Health Care Enforcement and Compliance Matters Prevention, Compliance, Advocacy

Tag Archives: Audits

The Mixed-Up Audit MICs

By Frank Sheeder on Posted in CMS, Enforcement, Government Initiatives, Medicaid, OIG, RACs, Uncategorized, Waste

The Department of Health and Human Services – Office of Inspector General (HHS-OIG) recently released a report entitled Early Assessment of Audit Medicaid Integrity Contractors.  The OIG assessed the efforts of the Audit Medicaid Integrity Contractors (Audit MIC) to identify overpayments in Medicaid.  The findings show that the audit process was broken and resulted in… Continue Reading

Update: OIG’s Intensive Hospital Audits

By Frank Sheeder on Posted in Enforcement, Government Initiatives, OIG

We addressed the OIG’s ongoing intensive hospital audits in two previous posts: OIG Has New, Intensive Hospital Compliance Initiative, and More About OIG’s Intensive Hospital Audits — Required Reading.  This post updates those discussions based on some recent audit reports. OIG has audited some new issues: Inpatient claims with same-day discharge and readmissions. Inpatient claims for 1-day… Continue Reading