OIG

Office of Inspector General voluntary disclosures — should I or shouldn't I?

Office of Inspector General voluntary disclosures — should I or shouldn't I?

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Nursing facility operators might be faced with this dilemma: Should I or shouldn't I provide an overpayment self-disclosure to the Department of Health and Human Services Office of Inspector General? This voluntary disclosure should be assessed with a cost benefits analysis lens while being mindful of the associated nuances.

Watchdog says nearly one-third of CMS telehealth payments were improper

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The growing drumbeat for greater use of telehealth in long-term care may have encountered a muffler.

Therapy overpayments may surpass $700 million a year, OIG suggests

Therapy overpayments may surpass $700 million a year, OIG suggests

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A federal review of outpatient physical therapy payments found Medicare likely overpaid $367 million during a six-month period.

Skilled nursing company pays $142k to settle allegations of prohibited-employee use

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Southwest Trinity Management has agreed to a $142,000 settlement to resolve allegations that a skilled nursing facility it owns and manages employed a nurse who was excluded from participating in any federal healthcare program.

Also in the News for Tuesday, Dec. 19

Owner of FL nursing home where 12 residents died from heat once warned air conditioning failure would be 'catastrophic'... OIG says long-term care insurers can build provider networks for discounts ... More than one HHS agency given instructions on words to avoid ...

OIG touts nursing home crackdowns to Congress

OIG touts nursing home crackdowns to Congress

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A federal agency's "early alert" on cases of potential abuse in nursing homes was spotlighted in its semiannual report to Congress on Thursday. The alert came from the Department of Health and Human Services' Office of Inspector General.

Hatch calls for answers from HHS on abuse, neglect in long-term care facilities

Hatch calls for answers from HHS on abuse, neglect in long-term care facilities

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Sen. Orrin Hatch (R-UT) urged the Department of Health and Human Services on Friday to divulge information on nursing home abuse, following a scathing federal report that found more than a quarter of potential abuse incidents go unreported.

State officials didn't verify correction of more than half of SNF deficiencies: report

State officials didn't verify correction of more than half of SNF deficiencies: report

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Health officials in Kansas failed to follow up on 52% of deficiencies identified during nursing home surveys, a federal watchdog said in a report released Monday.

CMS and providers have reason to celebrate

CMS and providers have reason to celebrate

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I encourage providers to pause and pat themselves on the back. That's because 30-day hospital readmission rates have dropped in all states except one over the past five years.

SNF therapy billing controversy rises from the dead

SNF therapy billing controversy rises from the dead

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Despite my love of Halloween, there is one component of it that is distinctly not for me: Horror movies. Still, I'm enough of a pop culture enthusiast that I can appreciate those with an appetite for scary movies and their sequels. If you want to watch the 10 "Halloween" movies or six versions of "Paranormal Activity," I'm not going to judge you. (Much.)

Poorly coded doctor claims cost Medicare $33 million: OIG report

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The Health & Human Services' Inspector General is advising the agency to have its Medicare contractors chase down more than $33 million that might have been overpaid to physicians as a result of seemingly innocent coding errors for services.

Also in the News for Tuesday, March 24

OMB begins review of Medicaid managed care ... Medicaid expansion has led to surge in diabetes diagnosis...Statins can stop for terminal patients, researchers advise

Connecting the hospice compliance dots

Connecting the hospice compliance dots

If someone asked you if your hospice was compliant with the Centers for Medicare & Medicaid Office of Inspector General's Effective Compliance Program Guidance for Hospice, what would you tell them?

Inspector General blasts agency for ignoring ZPIC scrutiny

Inspector General blasts agency for ignoring ZPIC scrutiny

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Ignoring a four-year-old warning to more thoroughly evaluate Medicare auditing contractors is among the pile of unheeded advice that could have saved the Medicare program billions of dollars in recent years, the Health and Human Services' Office of Inspector General charged Tuesday.

OIG says critical access swing beds should be paid at SNF rates

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New legislation should be introduced to significantly change the way rural-based hospitals are reimbursed for care provided in post-acute care swing beds, the Department of Health and Human Services' Office of Inspector General told the Centers for Medicare & Medicaid Services this week.

OIG: Government should consider more drug substitution

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Drug substitutions saved the government $13 million last year, but more drug substitutions under Medicare Part B would have saved an additional $6 million, the Office of Inspector General for Health and Human Services concluded in a recent report to Congress.

CMS delays repayment final rule a year

CMS delays repayment final rule a year

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The Centers for Medicare & Medicaid Services on Tuesday made official its plan to postpone implementation of a new rule on collecting hundreds of millions of dollars in overpayments until Feb. 16, 2016 — but providers remain on the hook for returning the money before then.

A time for providers to savor the good

A time for providers to savor the good

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It's true that there is danger in not stopping to smell the roses. Yet, in long-term care, it's understandable if you do just that, given how many hassles are tossed your way.

State disputes OIG findings, won't seek $9 million via competitive bidding

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The New York Department of Health will not competitively bid durable medical equipment despite a new OIG report that says the state could have saved its Medicaid program nearly $9 million over a two-year period.

Rides for loved ones a reasonable benefit, AHCA claims

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Operators should be able to offer free or discounted rides to the loved ones of residents being transported to skilled care facilities, asserts a letter from the American Health Care Association.

Daybreak Venture to pay $360,000 settlement over employment of excluded workers

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Skilled nursing operator Daybreak Venture has agreed to pay more than $357,000 to settle charges that it employed workers excluded from federal health programs, authorities recently announced.

Nursing home background checks, foot care being scrutinized by OIG

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Government investigators are preparing reports on skilled nursing facilities' Part B billing practices and background check processes, according to the recently released annual work plan from the Health and Human Services Office of Inspector General.

Reporting neglected, OIG says

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Slightly more than half of the nation's nursing facilities reported abuse or neglect allegations as required in 2012, a new report from the Office of Inspector General alleges. Such relatively low compliance indicates that more guidance and oversight is warranted, the report concludes.

Medicare Part B could have saved $110 million, OIG asserts

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If the Medicare Part B program had used average Medicare Part D drug dispensing and fee rates, it would have saved the government $110 million in 2011, according to a report from the Department of Health and Human Services Office of Inspector General released Sept. 16.

Nursing homes face federal False Claims Act charges for allegedly overmedicating residents with antipsychotics, other drugs

Nursing homes face federal False Claims Act charges for allegedly overmedicating residents with antipsychotics, other drugs

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Two California nursing homes routinely overmedicated residents with antipsychotics and other drugs "for the convenience of management," according to federal charges announced Wednesday by the 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.

Ask the payment expert ... about Medicare audit guidelines

Ask the payment expert ... about Medicare audit guidelines

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What guidelines should we use for a Medicare audit?

The benefits of a successful discharge plan

The benefits of a successful discharge plan

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It is critical to have a solid system for discharge planning that begins even before the resident is admitted to the facility. Individualized, resident-centered discharge planning will provide a solid system for quality transition and a crucial component of care at the preadmission assessment process.

Also in the news for June 3, 2014 . . .

Social involvement is No. 1 influence on nursing home residents' daytime sleep ... OIG casts doubt on managed care tax ... In potential Alzheimer's breakthrough, scientists use light to erase, restore rats' memories

Feds: Without more funds, we are cutting provider oversight

Feds: Without more funds, we are cutting provider oversight

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Nursing providers could feel reduced heat from federal Medicare and Medicaid oversight activities — if an agency official's testimony is to be believed as more than just budget-request bluster.