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Office of the Inspector General Health Care Providers Skilled Nursing Facility

Alston & Bird

Health Care Week in Review: CMS Releases IPPS Proposed Rule; Congress Holds Hearings on Chronic Care and Telehealth

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Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Holland & Knight LLP

OIG to Audit CMS Oversight of Nursing Home Surveys by Third-Party Contractors

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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), a top federal watchdog tasked with overseeing Medicare, Medicaid and other HHS programs, recently announced that it will audit the...more

Bricker Graydon LLP

A Long-Awaited Change: OIG Updates its Compliance Program Guidances

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From 1998-2008, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) published compliance program guidelines for various industries in the Federal Register....more

Arnall Golden Gregory LLP

Changing With the Times: OIG’s New “General Compliance Program Guidance” Expands Focus to New Industry Stakeholders and Updates...

The U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) recently published a new resource titled General Compliance Program Guidance (“GCPG”), which is described as a reference guide for the...more

Arnall Golden Gregory LLP

OIG Developing Updated Compliance Guidance for Hospices and Other Providers

Over the last three decades, the OIG has developed a series of voluntary compliance program guidance documents (“CPGs”) directed at various segments of the healthcare industry, such as hospitals, nursing homes, and hospices....more

Ballard Spahr LLP

HHS OIG to Review CMS Citations

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Summary - The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more

Womble Bond Dickinson

[Webinar] First Annual Health Care Fraud Symposium - March 14th, 12:00 pm - 1:30 pm ET

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Health Care fraud is a growing national issue. The National Heath Care Anti-Fraud Association estimates that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation's $2.26 trillion in...more

McDermott Will & Emery

Healthcare Regulatory Check-Up Newsletter | August 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant enforcement activity between July 21 and August 20, 2022. Key updates include a case in which the US Court of Appeals for the Eighth Circuit...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | July 2022 Recap

This issue of McDermott’s Healthcare Regulatory Check-Up highlights significant activity between June 21 and July 20, 2022. During this period, the Supreme Court of the United States overturned Roe v. Wade, which historically...more

McDermott Will & Emery

Healthcare Regulatory Check-up Newsletter | May 2022 Recap

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This issue of McDermott’s Healthcare Regulatory Check-Up highlights notable enforcement activity between April 21 and May 20, 2022, including a telemedicine case involving $64 million in false and fraudulent claims. We also...more

Maynard Nexsen

SMRC Targets for 2022: After Heavy Focus on Hospice, the SMRC Moves On to Home Health and Other Projects

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The Supplemental Medical Review Contractor (“SMRC”) is a Centers for Medicare and Medicaid Services (“CMS”) contractor authorized to conduct nationwide medical reviews (Medicare Part A, Part B, and DME). As many in the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 15. News Briefs: April 2021 #3

Report on Medicare Compliance 30, no. 15 (April 19, 2021) - CMS’s supplemental medical review contractor (SMRC) has added outpatient therapy claims to its list of postpayment reviews, according to its website. The SMRC,...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021

Report on Medicare Compliance 30, no. 8 (March 1, 2021) - According to a CMS spokesperson, “CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause...more

McGuireWoods LLP

U.S. House Passes American Rescue Plan – 15 Provisions for Healthcare Providers

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In the early morning of Feb. 27, 2021, the U.S. House of Representatives narrowly passed H.R. 1319, the American Rescue Plan Act of 2021, by a 219-212 vote. Two Democrats joined with a united Republican caucus to oppose the...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 7. News Briefs: February 2020 #4

Report on Medicare Compliance 29, no. 7 (February 24, 2020) -  Guardian Elder Care Holdings Inc., which operates more than 50 skilled nursing facilities (SNFs) in Pennsylvania, Ohio and West Virginia, and its related...more

Arnall Golden Gregory LLP

OIG Study Highlights How High-Performing ACOs Controlled Costs and Improved Quality by Working Collaboratively with SNFs and HHAs

On July 19, 2019, the Office of Inspector General (OIG) noted seven successful strategies used by twenty high-performing Accountable Care Organizations (ACOs) to reduce spending and improve quality of care. ...more

Mintz - Health Care Viewpoints

OIG Reports Focus on Hospice Quality of Care

Earlier this month, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) released two reports regarding its concerns and recommendations related to quality of care at hospice facilities....more

Bricker Graydon LLP

OIG, DOJ put hospice providers under a microscope

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The Office of Inspector General’s (OIG) recent report, “Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio,” calls out a number of areas where the OIG identified room...more

Baker Donelson

OIG August 2018 Work Plan Update

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The OIG added 12 new items to its Work Plan in the August 2018 update. Hot topics related to Centers for Medicare & Medicaid Services (CMS) oversight in this month's Work Plan include: state oversight of opioids; potential...more

Mintz - Health Care Viewpoints

The OIG Identifies “Significant Vulnerabilities” in the Medicare Hospice Program: What This Might Mean for Hospice Providers?

Last week, the Department of Health and Human Services – Office of Inspector General (“OIG”) released a portfolio report identifying multiple vulnerabilities in the Medicare Hospice Program (the “Hospice Portfolio Report”),...more

Arnall Golden Gregory LLP

OIG Issues Report on Hospice Program Vulnerabilities

In July 2018, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a report entitled, Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity...more

King & Spalding

Signature HealthCARE to Pay $30 Million to Resolve Medicare Fraud Allegations

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Signature HealthCARE (Signature), a Kentucky-based owner and operator of 115 skilled nursing facilities across ten states, has reached an agreement with the HHS OIG to settle a False Claims Act lawsuit in which it was accused...more

K&L Gates LLP

K&L Gates Triage: Ride Sharing and Health Care Regulatory Considerations

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Transportation is often cited as one of the top barriers to health care for individuals in the United States. To reduce this burden and increase access to care, many health care providers are now partnering with ride-sharing...more

Baker Donelson

Nursing Facility Discounts Approved in OIG Advisory Opinion 17-08

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The OIG created an opening for nursing facility discounts to private payors when it approved a startup company's proposal to create a network of nursing facilities willing to offer discounts on the daily rates charged to...more

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