Office Of Inspector General

OIG: Nursing homes correctly reported 53% of abuse or neglect allegations in 2012

OIG: Nursing homes correctly reported 53% of abuse or neglect allegations in 2012

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Only about half of nursing facilities correctly reported abuse or neglect allegations in 2012, indicating that the government needs to provide more guidance and oversight, according to a new report from the Office of Inspector General.

OIG revenues off $1 billion as oversight relaxes

OIG revenues off $1 billion as oversight relaxes

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Revenues from Department of Health and Human Services Office of Inspector General audits and investigations for the the first half of fiscal 2014 are expected to drop almost $1 billion from the same period last year, bolstering previous revelations that dwindling federal funding for the agency could lead to less restrictive oversight in the year to come.

OIG finds 'observation stay' problems, calls for reform

OIG finds 'observation stay' problems, calls for reform

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Long-term care groups are among those hailing a federal study that raises critical questions about hospitals' apparent over-use of "observation stay" designations for patients.

Ask the payment expert ... about quality and reimbursement correlations

Ask the payment expert ... about quality and reimbursement correlations

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How can the Centers for Medicare & Medicaid Services correlate quality of care and reimbursement? You always need to remember that Medicare is an insurance plan. As such, Medicare has rules, just like your insurance company. Two of those rules are that we must provide care according to an individualized care plan for each resident and that we provide appropriate discharge planning.

Federal investigators find nursing home alternative a prime target for fraud, abuse

Federal investigators find nursing home alternative a prime target for fraud, abuse

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Medicaid personal care services are ripe for abuse, according to a new report from the Department of Health and Human Services' Office of Inspector General.

OIG: Medicare overpaid home health agencies $5 million in 2010 for dubious claims

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Home health agencies received $5 million in overpayments for dubious Medicare claims filed in 2010, federal investigators have found.

OIG: Cutting Medicare and Medicaid fraud still a top concern

Eliminating Medicare and Medicaid fraud should be a priority for the Department of Health and Human Services as it works to implement healthcare reform programs, according to a new report.

IG wants benchmark pricing for drugs

The Department of Health and Human Services Office of Inspector General would like to see a national drug pricing benchmark. In a letter to the Centers for Medicare & Medicaid Services, the IG said the move save on Medicaid reimbursement costs paid to pharmacies. The letter said most states use a "fundamentally flawed" method to calculate such payments. The report said CMS is in agreement and is taking steps to provide guidance to states on this issue.

Alleged overpayments to inpatient rehab facilities spark CMS review

Inpatient rehab facilities received an estimated $34 million in overpayments from Medicare between 2004 and 2007, according to a report from the Office of Inspector General. This has prompted a review by the Centers for Medicare & Medicaid Services.

OIG calls its healthcare suggestions 'priority recommendations'

The Office of the Inspector General for the Department of Health and Human Services has released a report highlighting recommendations, including some that could affect nursing homes.

Most hospice services in nursing homes fail to meet Medicare requirements, OIG finds

Most hospice services in nursing homes fail to meet Medicare requirements, OIG finds

A growing number of Medicare beneficiaries are receiving hospice care in nursing facilities. But most of these services do not meet Medicare requirements. That is according to two reports from the Office of the Inspector General of the Department of Health and Human Services.

Medicare overpaid millions for pressure ulcer prevention devices in 2007, report finds

About 86% of Medicare claims for certain support surfaces used to treat and prevent pressure ulcers did not meet coverage criteria in the first half of 2007. That resulted in millions of dollars in overpayments during that period, according to a new report from the Department of Health and Human Services Office of the Inspector General.

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