By Mark Spivey
Conspiracy ran for nearly 20 years, netting owner of assisted living and skilled nursing facilities $37 million. The primary orchestrator of what federal authorities called the most wide-reaching healthcare fraud scheme ever uncovered has been sentenced to 20 years in state prison – far short of the 30 years prosecutors…
June 20, 2019
By Kathy Seward, MD, CHCQM-PHYADV CMS Under-Reports Elder Abuse
Recent report from HHH/OIG faults CMS. A recent study by the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) revealed a concerning series of findings related to the under-reporting of instances of potential abuse and/or neglect of elderly Medicare patients. Every year, tens of thousands…
By Mark Spivey
OIG’s report to Congress profiles plenty of activity, including the ongoing battle against the opioid abuse epidemic. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) is in the business of rooting out “fraud, waste, and abuse” in the nation’s healthcare system, to echo the…
By Mark Spivey
Most of those accused of wrongdoing are medical professionals. The national opioid crisis has hit the heart of Appalachia particularly hard, and federal authorities are pulling out the stops in fighting it. U.S. Attorney General William P. Barr and U.S. Department of Health and Human Services (HHS) Secretary Alex M.…
By Mark Spivey
Two dozen individuals were charged in a landmark investigation historic in breadth. “A million dollars isn’t cool,” remarked pop star Justin Timberlake in the Oscar-winning 2010 film The Social Network, portraying entrepreneur Sean Parker as he advises a young Mark Zuckerberg and his associates in a nightclub amid the fledgling…
April 4, 2019
By Mark Spivey OIG Inspector Daniel Levinson Resigns
The head of the federal healthcare oversight body was a popular guest on Monitor Mondays. Daniel Levinson, Inspector General of the U.S. Department of Health and Human Services (HHS), is stepping down from his post at the end of May, following nearly 15 years in his position as healthcare’s top…
March 21, 2019
By Ronald Hirsch, MD OIG Audits Part A SNF Stays for Qualifying Inpatient Admissions – and the Results are Not Pretty
The federal watchdog did not, however, decide to demand recoupments. It is said that great minds think alike. And that proved to be true when the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released its report (CMS improperly paid millions of dollars…
March 14, 2019
By David M. Glaser, Esq. Consideration of Consultation
Hiring a consultant can be a high-risk activity. Don’t get me wrong; I am definitely not disparaging consultants in general. A good consultant can get you out of a jam. I regularly rely on the wisdom of consultants, including my fellow RACmonitor authors and Monitor Mondays panelists, while assisting clients. But as…
February 7, 2019
By Mark Spivey CMS Audit Performance Gauged in HHS OIG Announcement
CMS squeaks by with B-plus in OIG audit. If the Centers for Medicare & Medicaid Services (CMS) received a grade for its audit performance during the 2015 and 2016 fiscal years, it would have been about a B-plus, maybe waived up to an A-minus, according to an announcement made recently…
January 24, 2019
By Mark Spivey OIG: CMS Did Not Always Resolve Audit Recommendations
CMS audit performance gauged in HHS OIG announcement. If the Centers for Medicare & Medicaid Services (CMS) received a grade for its audit performance during the 2015 and 2016 fiscal years, it would have been about a B-plus, maybe waived up to an A-minus, according to an announcement made this…
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