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
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
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
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
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
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
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!
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...
Texas TULIP Challenges for Nursing Facility Administrators
The Texas Unified Licensure Information Portal (TULIP) is state’s web-based licensure system for the Health and Humans Services Commission (HHSC). TULIP was designed for licensed long-term care facilities and agencies,...