Updates

Audit

OIG Issues Recommendations for Short Stay Admissions

The OIG conducted an audit to evaluate the effectiveness of Medicare program safeguards to ensure appropriate reimbursement of short stay inpatient admissions.  In general, inpatient admissions which are not expected to last at least two midnights are not considered to be appropriate.  However, an inpatient stay of less than two

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Audit

OIG Semiannual Report to Congress

The OIG has issued their Semiannual Report to Congress for the period October 1, 2023 through March 31, 2024.  The report highlights over $2.76 billion in expected investigative and audit recoveries identified during the first half of FY 2024.  The report details the OIG’s ongoing work through investigations and enforcement

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CERT

2023 Medicare Improper Payments Data

The 2023 Medicare Fee-For-Service Improper Payments Report was just released.  The report identified an estimated $31.23 billion in improper payments with a payment error rate of 7.38%. The report outlines findings related to services most frequently billed and paid in error and outlines the reasons for the errors such as

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Compliance

OIG Semiannual Report to Congress

The OIG has issued their Semiannual Report to Congress for the period April 1, 2023 through September 30, 2023.  The report highlights $3.44 billion in expected investigative and audit recoveries identified during the entirety of FY 2023. The report also details the OIG’s ongoing work through investigations and enforcement actions over the past

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Compliance

New Requirements for Hospital Price Transparency in 2024

The 2024 OPPS Final Rule was published last week and contained significant updates and changes to the hospital price transparency rules, many of which are effective January 1, 2024.  Although there is no grace period, some requirements will be phased in. The new requirements come on the heels of the

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Compliance

The OIG Issues New Compliance Guidance

Office of Inspector General (OIG) released their new General Compliance Program Guidance (GCPG) today and it is a must-read for all healthcare compliance professionals. The document outlines new, extensive, expectations for corporate compliance programs.   The 91 page document contains numerous “tips”, regulatory citations and links to additional resources. The OIG

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