Home Health Agencies and Skilled Nursing Facilities Among Those Providers Included in the OIG’s Compendium of Priority Recommendations

The March 2014 edition of the Department of Health and Human Services Office of Inspector General (OIG’s) Compendium of Priority Recommendations lists the OIG’s 25 “priority recommendations.” Some of the provider types that are specifically mentioned in the report, and likely to see increased scrutiny from the OIG, include: 1. Home Health Agencies. The OIG alleges that one in every four home health agencies (HHAs) exhibited “questionable billing.” Recommendations include implementing and improving claims processing edits to prevent “inappropriate payments,”… Read More >

OIG Report finds CMS and its contractors failed to address fraud vulnerabilities in electronic health records

A recent report by the Office of Inspector General (OIG) concluded that CMS and its contractors have failed to adopt program integrity measures focused on fraud vulnerabilities with the use of electronic health records (EHR).  Recognizing that EHR technology may make it easier for individuals to perpetrate fraud, the OIG found that CMS and its contractors had not adequately adjusted their review practices. The report addressed several specific ways in which EHR documentation practices can make it easier for individuals… Read More >

OIG Extends Electronic Health Records Safe Harbor Under the Anti-Kickback Statute

The Office of Inspector General (“OIG”) released the final rule amending the safe harbor regulation for electronic health records items and services.  The final rule, published in the December 27, 2013 Federal Register, extends the safe harbor until December 31, 2021; updates the provision under which electronic health records software is deemed interoperable; removes the requirement for electronic prescribing capability; excludes laboratories from protected donors; and clarifies the condition that prohibits a donor from taking any action to limit or… Read More >