Lexology September 24, 2018
Providers, plans, and vendors that provide services under the Medicare Advantage program, should be aware that the Office of Inspector General (“OIG”) of the U.S. Department of Health and Human Services (“HHS”) is once again focusing its oversight on Part C rules.
The OIG develops and prioritizes its Work Plan through the identification of areas that may pose a significant risk, focusing primarily on fraud, waste and abuse, health care industry compliance, and the exclusion of persons or entities violating the law. The OIG has broad investigative authority to ensure that it is promoting efficiency and mitigating fraud, waste, and abuse of federal government programs.[1]
If violations are detected through the various medical record reviews identified in the OIG’s Work...
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