OIG Report Recommends CMS Use CERT Data to Identify High Risk Home Health Agencies

CMS Remains Opposed to Using CERT Data to Identify Improper Payments, Prefers TPE & RCD The Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report pertaining to home health agencies (HHA), The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home…

OIG Finds Medicare Part D Still Spending Millions for Hospice Drugs

Over recent years the Department of Health & Human Services Office of the Inspector General (OIG) and others have conducted analyses of spending outside of hospice while patients are on service and determined that Medicare may be paying separately for care (including prescription drugs under Part D) that should be the responsibility of the hospice. …

OIG Report Finds States Need to Do More on Background Checks for Long-Term Care Workers

A new report from the Office of Inspector General (OIG) of the Department of Health and Human Services finds that nine of the 11 states that concluded their participation in the National Background Check Program in 2017 and 2018 did not implement all of the selected Program requirements, primarily due to a lack of legislative…

After OIG Reports, House Committee Seeks More Info on Hospice Deficiencies

In response to two reports issued by the Department of Health and Human Services Office of the Inspector General (OIG) targeting hospice survey deficiencies and quality of care, House Ways and Means Committee Chair Richard E. Neal (D-MA) and Ranking Member Kevin Brady (R-TX) are seeking more information from Centers for Medicare & Medicaid Services…

Update on the OIG Report on Potential Abuse or Neglect of Patients

Earlier in July, the OIG released a report, CMS Could Use Medicare Data to Identify Instances of Potential Abuse or Neglect, (see NAHC Report coverage here) discussing how the OIG identified potential cases of abuse or neglect utilizing diagnosis codes on claims for beneficiaries treated in emergency rooms. In this report, the OIG also identified…

OIG Releases Two Reports Targeting Hospice Survey Deficiencies and Quality of Care

Earlier this week the HHS Office of the Inspector General (OIG) issued two reports representing in-depth study of findings from Medicare hospice recertification and complaint surveys. One report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, provides broad findings on frequencies of deficiencies and recommends greater public access to survey findings as well as increased CMS-sponsored…

Office of Inspector General Continues Focus on Home Health Agencies

The Department of Health and Human Services (HHS), Office of the Inspector General (OIG) issues updates to its work plan on a monthly basis through out the year. Since our last report on the OIG’s recent activity updates (NAHC Report https://report.nahc.org/recently-added-oig-work-plan-item-may-impact-home-health-and-hospice-providers/), the OIG announced this month a revision of an issue for home heath agencies…

OIG: CMS & States Must Work Together on Background Checks for Long-Term Care Employees

The Centers for Medicare & Medicaid Services (CMS) must help states completely implement background checks for long-term caregiver employees, according to a new report released by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS). Nine million beneficiaries rely on long-term-care services each year for safe, dependable care and…

Recently Added OIG Work Plan Item May Impact Home Health and Hospice Providers

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) work planning is dynamic and adjustments are made throughout the year to meet priorities and to anticipate and respond to emerging issues. A Work Plan has been developed, made public, and updated monthly with new issues.  This month, there are two new issues…

OIG: Non-Profit Hospital May Offer Free Home Care

A federal rule against offering patients free care does not prohibit a hospital from providing free home care if the goal is to reduce readmissions, according to an advisory opinion the Office of Inspector (OIG) General of the Department of Health and Human Services. The federal government forbids the provision of free services to patients…