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McBrayer Blogs
Showing 62 posts in Medicare.
ON THE ENFORCEMENT RADAR: MEDICAID AUDITS AND THE 2012 OIG WORK PLAN
Posted In Health Care Law, Kentucky’s Department for Medicaid Services, Medicaid, Medicare, Office of Inspector General of the United States Department of Health and Human Services (OIG)
Unlike the Department of Health and Human Services Office of Inspector General (“OIG”) which publishes a Work Plan each year, the Department of Medicaid Services (“Medicaid”) generally does not publish guidance on the areas which it plans to investigate and/or audit. In fact, Medicaid’s website states … “Medicaid does not provide guidance on how companies should bill for services, but will direct you to applicable regulations. If you receive direction from staff about how to bill, the Department will not be bound by such instruction, unless it was given by a Director or Commissioner.” Because the federal integrity programs are now moving through the process, Kentucky Medicaid providers are starting to see lots of audit activities. Unlike the OIG audits, we don’t know the precise subject matter of the Medicaid audits, but the process for appeal is outlined below in addition to the areas announced for review by the OIG. More >
ON THE ENFORCEMENT RADAR: THE 2012 OIG WORK PLAN
Posted In Health Care Law, Medicaid, Medicare, Office of Inspector General of the United States Department of Health and Human Services (OIG)
The Office of Inspector General of the United States Department of Health and Human Services (OIG) released its Work Plan for fiscal year 2012. At the beginning of each fiscal year, the OIG issues its annual Work Plan, which describes current audit, enforcement and evaluation activities and those the agency plans to initiate in the upcoming year. The Work Plan also provides a general view of the OIG’s investigative, enforcement and compliance activities. Basically, the Work Plan informs health care providers what is on the OIG’s enforcement radar in the coming year. Physicians should know what areas that the OIG is concerned about and review their own practices to ensure compliance with regulatory requirements. The following are some of the highlights from the FY 2012 Work Plan. More >
