CMS’s Controls Related to Hospital Preparedness Not Sufficient

Angie SzumlinskiNews

The US Office of Inspector General recently conducted an audit to assess CMS’s controls related to hospital preparedness for emerging infectious diseases. According to their report on the audit, they “reviewed the design and implementation of CMS’s controls regarding the approximately 500 hospitals certified to participate in Medicare and Medicaid by State survey agencies under contract with CMS. We also …

Eye Watching

OIG Investigates Florida Reporting Practices

Angie SzumlinskiNews

Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents 03-04-2021 | A-04-17-08058 | Complete Report | Report in Brief Why OIG Did This Audit This audit report is one of a series of OIG reports addressing the identification, reporting, and investigation of incidents of …

Home Health – OIG

Angie SzumlinskiNews

When a public health emergency was declared last March, the Centers for Medicare & Medicaid Services (CMS) issued a variety of waivers allowing home health providers to more easily provide telehealth services during the crisis. Now the Office of Inspector General (OIG) has announced an audit, dubbed the “HHA Telehealth Project,” that will examine home health providers’ usage of telehealth …

American Flag With Lock

Latest LEIE File Released

Angie SzumlinskiLegal

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in October 2019.

OIG’s Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs

Angie SzumlinskiAnnouncements

Last July the Office of Inspector General released it’s annual report Solutions to Reduce Fraud, Waste and Abuse in HHS Programs: OIG’s Top Recommendations. In it, the top 25 unimplemented recommendations are identified along with the 25 recommendations from 2018 that were put in place. CMS has not implemented the recommendations from the OIG yet, but they have published a …

Request for Criminal Background Check

OIG Background Checks

Angie SzumlinskiCompliance

Although long-term care providers have been required to perform criminal background checks for many years, the national data base is not accessible to providers. In a recent article published in Provider Magazine, Mark Parkinson, CEO of AHCA/NCAL and David Gifford, MD, Senior Vice President of Quality and Regulatory Affairs at AHCA discussed a recent OIG report on the effectiveness of …


This Could Be You!

Angie SzumlinskiCompliance

The OIG is inspecting nursing facilities to identify whether they are in compliance with the Life Safety Code and Disaster Preparedness. In this article, the OIG discusses the 2016 updated life safety and emergency preparedness regulations aimed at improving care. The OIG made the decision to visit nursing facilities to ensure compliance with the regulations. The visits were conducted in …

Senior Woman

OIG Discovers Abuse and Neglect at Skilled Nursing Facilities Not Always Reported or Investigated

Angie SzumlinskiLegal

The Office of Inspector General (OIG) determined the prevalence of incidents of potential abuse or neglect of Medicare beneficiaries residing in skilled nursing facilities who had an ER Medicare claim in 2016 with a high-risk diagnosis code, whether these incidents of potential abuse and/or neglect were properly reported by the SNFs, whether the Centers for Medicare and Medicaid Services (CMS) …

American Flag With Lock

Office of Inspector General – List of Excluded Individuals/Entities: May 2019

Angie SzumlinskiLegal

OIG has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Those that are excluded can receive no payment from Federal healthcare programs for any items or services they furnish, order, or prescribe. This includes those that provide health benefits funded directly or …

OIG Releases Study on the Assessment of State Background Checks for LTC Providers

Angie SzumlinskiAnnouncements, Compliance

The National Background Check Program (Program) provides grants to States to develop systems to conduct background checks of State and Federal criminal history records for prospective long-term-care employees. Congress mandates that the Office of Inspector General evaluate various aspects of Program implementation. This report provides an assessment of States that concluded Program participation prior to 2017, and it also provides …