Management Performance Associates

    OIG Resources

    The Department of Health and Human Services Office of Inspector General (OIG) is charged with fighting Medicare and Medicaid fraud, abuse and waste. The OIG conducts audits and investigations, files lawsuits and issues penalties to enforce healthcare fraud and abuse laws. The OIG website offers compliance resources for providers: https://oig.hhs.gov/compliance

    Compliance Guidance:

    The OIG has published two sets of voluntary compliance guidance for nursing facilities:

    OIG Compliance Guidance for Nursing Facilities

    Supplemental OIG Compliance Guidance for Nursing Facilities

    OIG Reports:

    The Medicare Payment System for Skilled Nursing Facilities Needs to Be Reevaluated

    Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring

    Questionable Billing by Skilled Nursing Facilities 2010

    SNFs Often Fail to Meet Care Planning and Discharge Planning Requirements

    Inappropriate Payments to SNFs Cost Medicare More than a Billion Dollars in 2009

    The OIG’s Semi-Annual Report to Congress

    Employee Screening:

    OIG database of Excluded Providers

    Self-Disclosure:

    Information about the Self-Disclosure Protocol

    Board resources:

    Resources to help your board exercise oversight over compliance

    Work Plans:

    The OIG Work Plans. Every year, the OIG issues a Work Plan for the upcoming Fiscal Year. The Work Plan tells providers what the OIG will be investigating in the upcoming Fiscal Year. By reading the Work Plan, providers can address high-risk compliance areas and improve their performance in areas of government concern–and stay out of hot water.

    Sign up for Email Updates from the OIG and other parts of the Department of Health and Human Services.

     

    Myth #3

    Compliance is a waste of time.

    The Truth:

    Compliance is an opportunity to mitigate penalties, reduce whistleblowing, reduce liability, enhance reputation, improve quality and claims accuracy, and improve your operations.