Tag Archives: OIG

Anthem OIG Audit Reveals Coding Issues

Last month, the Office of Inspector General published the report of a compliance audit conducted on one of Anthem Community Insurance Company, Inc.’s Medicare Advantage (MA) contracts.  The OIG concluded that Anthem was overpaid by $3.4 million.  MA plans’ payments … Read Full Post

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OIG Finds Errors in Humana Compliance Audit

When the Centers for Medicare and Medicaid Services (CMS) risk adjustment data validation (RADV) audit identified coding errors for one Humana contract representing members in South Florida, the Office of Inspector General (OIG) conducted its own audit.  We should recall … Read Full Post

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Easy Personnel Mistakes to Avoid

As with every business, there are myriad laws and administrative rules with which a home health care organization must comply. However, health care is among the most regulated industries and subject to a wide spectrum of regulatory compliance challenges. Whether … Read Full Post

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What We’re Reading – Inappropriate Billing, Fraud Gaining Scrutiny

Despite the pandemic, the U.S. Department of Health and Human Services – Office of the Inspector General (HHS-OIG) has not missed a beat. Regulators are still focusing on fraud and non-compliance. This article refers to a bulletin,  issued in February … Read Full Post

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OIG Says CMS Misses the Forest for the Trees

In honesty, OIG didn’t come out and make that statement, but after reading a just-released report, missing the forest for the tress is exactly what seems to have happened.  The Office of Inspector General (OIG) provides auditing services for the … Read Full Post

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