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Highlights from the HHS-OIG 2023 Spring Semiannual Report

Provider Trust

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders.

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COVID-related enforcement actions 

YouCompli

Healthcare compliance history has shown that when the government disperses significant funds, audits and enforcement associated with the disbursement of those funds will shortly follow. The Federal government spent unprecedented trillions of dollars throughout the COVID public health emergency (PHE). Let’s look at a few.

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What Is Involved With a Healthcare CMS Inspection?

MedTrainer

Watch this one-demand webinar for insider tips straight from seasoned compliance surveyors. Additionally, CMS’s guidelines, or Conditions of Participation/Conditions for Coverage (CoPs/CfCs) , are specific to each type of covered health care facility, along with regulations pertaining to each organization’s state and locality.

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Three Individuals Charged for Providing Fraudulent COVID-19 Vaccination Cards for Employment Purposes

Healthcare Compliance Blog

A mother and her two daughters have been charged for providing fraudulent COVID-19 vaccination cards to maintain and obtain employment at a New York nursing home. Vaccination is mandatory for nursing home employment in New York. Bassett stated, “Vaccination fraud is a serious crime.

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2024 HHS-OIG Top Areas of Focus

Provider Trust

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. Unfortunately, Medicare Advantage programs are not exempt from instances of fraud, waste, and abuse.

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DOJ Recouped $2.2 Billion Under FCA in 2022

Hall Render

This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. Over 77% of the funds recovered were related to the health care industry, which shows the federal government’s commitment to enforcing the FCA. Health Care Fraud Actions Medicaid.

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The Cobra Effect & Enforcing Compliance Standards

AIHC

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.”