First few Article Sentences
Facilities are now faced with audits from many sides. Audits overlap one another and duplicate requests for the same files can be overwhelming. There are currently 16 different fraud audits in effect. I’ve listed some recent developments in the Medicare and Medicaid fraud and abuse arena and provided several insightful tips from our firm on dealing with the tangled layers of fraud audits your facility may encounter. There is now a new focus particularly on CAH, Rural Health and IHS facilities.
The OIG
The Office of Inspector General (OIG) has released its compliance guide directed at Boards of health care entities. Increased scrutiny at the Board level will determine whether there are processes in place to effectively monitor compliance issues. Boards may now be held personally accountable for their decisions. For example, in New York, a State Attorney General forced a hospital to replace the entire Board as part of the Plan of Correction in a fraud audit case.