Blog

HCFAC Turns 25 & Continues to Thrive in the Fight Against Fraud

August 23, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a national Health Care Fraud and Abuse Control Program (HCFAC or Program) under the joint direction of the Attorney General and the Secr...

The OIG Opines regarding Loaned Smartphones for Low Income Patient Access to Care

August 4, 2022

During the PHE, access to care was limited and social isolation was real. To increase access, the Centers for Medicare & Medicaid Services (“CMS”) through blanket waivers and state  Medicaid programs tempora...

The Lone Star State’s Commitment to Exclusion Screening

July 22, 2022

The Texas Office of the Inspector General for the state’s Health and Human Services agency recently published a reminder about the significance of exclusion screening. Texas, like many states, maintains a state exclusi...

DOJ False Claims Highlights in 2021 and What to Expect Ahead

July 8, 2022

Over the past 5 years, there has been a decreased in false claims recoveries by the DOJ. That trend was resoundingly reversed in fiscal year 2021. In a press announcement on February 1, 2022, the DOJ released the foll...

Screening Volunteers Against Exclusion Lists – Things to Consider

June 30, 2022

Background In 2013, the OIG issued an updated revised bulletin regarding the effect of exclusion from participation in federal programs. As part of that bulletin, the OIG addressed a number of somewhat gray areas incl...

Updates on Data Modernization Efforts by the OIG 

June 24, 2022

At the March 29, 2022 Health Care Compliance Association (HCCA) conference, Christi A. Grimm, HHS-OIG Inspector General, presented an update on key agency initiatives and priorities that directly impact health care and c...

COVID-RELATED FRAUD REMAINS A TOP LAW ENFORCEMENT PRIORITY

June 2, 2022

Even though COVID-19 seems to be receding in the minds of many, it continues to be the source of significant law enforcement actions at the federal level. COVID-related criminal investigations and prosecutions, from a fr...

The OIG 2021 MFCU Performance Report Highlights

May 30, 2022

Background The function of state Medicaid Fraud Control Units (MFCUs) is to investigate and prosecute Medicaid provider fraud and patient abuse/neglect. The Social Security Act requires each state to operate a MFCU. M...

Interested in Telehealth? So is the OIG!

May 18, 2022

Telehealth had been a small part of healthcare for many years, but the declaration of a Public Health Emergency (PHE) in 2020 accelerated both its use and scope when in-person healthcare services were simply not availabl...

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