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Managed Care HHS-OIG

The HHS-OIG Strategic Plan for Oversight of Managed Care for Medicare and Medicaid has three goals: Promote access to care for people enrolled in managed care. Provide comprehensive financial oversight. Promote data accuracy and encourage data-driven decisions. OIG developed the managed care life cycle to guide oversight and enforcement work.

Actived: 4 days ago

URL: https://oig.hhs.gov/reports-and-publications/featured-topics/managed-care/

Office of Inspector General Government Oversight U.S.

WebHHS-OIG has approximately 1,600 employees dedicated to government oversight, combating fraud, waste and abuse and to improving the efficiency of HHS …

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Compliance Office of Inspector General Government …

WebThis online training series includes web-based trainings, job aids, and videos for grantees and health care providers who serve AI/AN communities to learn more about …

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Report Healthcare Fraud

WebComplaint Who to Contact; Issues about Medicare policy, coverage, billing claims or appeals . Lost or stolen Medicare card. Medicare.gov 1-800-MEDICARE

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Report Healthcare Fraud

WebReport Healthcare Fraud. Which fraudulent action are you reporting? Improper billing. Kickbacks. Medically unnecessary services. Diversion/Prescription Fraud. Other.

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Nursing Homes HHS-OIG

WebLast Updated: 04-03-2024. Nursing homes are intended to be places of comfort and healing. According to Centers for Medicare & Medicaid Services (CMS) data, in July 2022, …

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General Compliance Program Guidance Office of …

WebThe General Compliance Program Guidance (GCPG) is a reference guide for the health care compliance community and other health care stakeholders.

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Information Blocking HHS-OIG

WebOn June 27, 2023, HHS-OIG posted its final rule implementing information blocking penalties . The final rule establishes the statutory penalties created by the 21st Century …

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Reports and Publications Office of Inspector General

WebOIG reports contain findings of its audits and evaluations, assess how well HHS programs and grantees/contractors are working, identify risks to the people they serve and to …

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Health Care Fraud and Abuse Control Program Report …

WebEfforts to combat fraud were consolidated and strengthened under Public Law 104-191, the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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Clinic Owner Sent To Prison For Orchestrating $15M Medicare …

WebClinic Owner Sent To Prison For Orchestrating $15M Medicare Fraud And Kickback Scheme. HOUSTON – The owner of a Houston-area mental health clinic has …

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IG Grimm Named Among Top Women Leaders in Health Care

WebThe recognition celebrates the outstanding accomplishments of women across the nation, highlighting their contributions to their organizations and efforts in …

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About OIG Office of Inspector General Government Oversight

WebWho We Are. Since its 1976 establishment, the Office of Inspector General (OIG) has been at the forefront of the Nation's efforts to fight waste, fraud and abuse and to improving …

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Doctor Charged With Unlawfully Distributing Controlled …

WebDoctor Charged With Unlawfully Distributing Controlled Substances And Health Care Fraud. A New Hampshire doctor made his initial appearance today in Burlington, …

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Fraud Office of Inspector General Government Oversight U.S

WebHHS-OIG has a long history of protecting the health and well-being of HHS beneficiaries, including residents in long-term care facilities such as nursing homes.

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CMS Did Not Ensure That Selected States Complied With Medicaid …

WebWhy OIG Did This Audit. In 2021, nearly 58 million adults in the United States experienced some form of mental illness, and an estimated 46.3 million people …

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Fraud Alert: COVID-19 Scams

WebScammers are using social media to perpetrate COVID-19-related scams. In one major scheme, fraudsters hack social media accounts and send direct messages to …

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Fraud & Abuse Laws

WebFraud & Abuse Laws. The five most important Federal fraud and abuse laws that apply to physicians are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the …

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Submit a Hotline Complaint Office of Inspector General

WebSubmit a Hotline Complaint. OIG Hotline Operations accepts tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement in the U.S. …

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Exclusions FAQs Office of Inspector General Government …

WebThe scope of an exclusion under section 1128 of the Act is from all Federal health care programs, as defined in 42 CFR 1001.2. Federal health care programs …

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Pharmacy Owner Sentenced To Four Years In Prison For Health …

WebPharmacy Owner Sentenced To Four Years In Prison For Health Care Fraud. Damian Williams, the United States Attorney for the Southern District of New …

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Attorney General Moody Announces Arrest Of Two Seminole …

WebAttorney General Moody Announces Arrest Of Two Seminole County Residents For Medicaid Fraud. TALLAHASSEE, Fla.—Attorney General Ashley Moody’s Medicaid …

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