OIG Wants CMS to Take a Scalpel to Surgery Costs

The Office of Inspector General (OIG) of Health & Human Services is recommending that CMS make a major reduction to the amount it pays hospitals for certain kinds of surgery.  Under the recommendation, Medicare would pay a hospital the ambulatory surgery center (ASC) rate rather than the hospital rate for …

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Attention Seniors! Check Into a Hospital and Get $100!

OIG Advisory Opinion 15-03 approves a Medigap insurer’s program that, among other things, calls for (a) network hospitals to waive the deductible for Medicare enrollees, (b) the insurer to pay the hospital network a fee each time it admits a Medicare enrollee, and (c) pay the Medicare enrollee $100 for being …

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This Just in: OIG Rules Free Diapers Are Not an Illegal Kickback

  The February Profile in Courage Award goes to the Office of Inspector General (OIG) of the Department of Health & Human Services.  In its very first Advisory Opinion of the year, the OIG has boldly proclaimed that a provider may give free diapers to Medicaid mothers without fear of federal …

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Government Joins Lawsuit Against Florida Doctor Alleging Fraud and Kickbacks

In a move demonstrating the government’s continued aim to combat health care fraud through its Health Care Fraud Prevention and Enforcement Action Team (HEAT), the Department of Justice announced today that the government has intervened in two qui tam lawsuits against a Florida cardiologist, Dr. Asad Qamar, and …

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Another Halloween Treat: the OIG’s 2015 Work Plan

On Halloween the Office of Inspector General (OIG) of Health & Human Services released its “Work Plan Fiscal 2015.”  The 90-page document is meant to tell the public, and especially health care providers paid by Medicare and Medicaid, where the OIG intends to focus its investigative time and resources …

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OIG Warns Pharma Its Copayment Coupons May Aid Crime

Brand name drugs cost a lot. So to make them more attractive, drug manufacturers issue coupons for discounts on the copayment portion of the price. They work the same as the dollar-off coupons offered by cereal manufacturers. There’s one big difference, though. If a senior citizen uses a coupon for Rice …

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