OIG Files: Vignettes of the Week

OIG Files: Vignettes of the Week

If you missed Eric opining on LinkedIn this week, here are some quick pieces of information including: an infectious disease doctor, a case in NJ, and a Bill that was signed into law. Another great case from my former OIG coworkers in NJ. This one should concern...
Come Fly with OIG

Come Fly with OIG

The National Association for Medicaid Program Integrity (NAMPI) Annual Conference brought us to Baltimore, MD just a few weeks after returning from Woodlawn, a neighboring area. It felt like the who’s who of the HHS-OIG greats and I felt lucky enough to spend a...
OIG Files: Go Your Own Way 

OIG Files: Go Your Own Way 

While CMS reported that is collected half of the overpayments previously identified by OIG, the OIG in another recent review (full report) found that number to substantially less. The OIG is the watchdog for HHS.  All OIGs serve in this role for the respective...
The Importance of Getting Risk Adjustment Right

The Importance of Getting Risk Adjustment Right

Background Anyone who has taken the CRC™ (Certified Risk Adjustment Coder) curriculum can tell you that risk adjustment was first utilized in the mid-90’s for Medicaid purposes. The goal of risk adjustment has always been to collect data on patients so that money...
OIG Files: A Disastrous Investigative Misstep

OIG Files: A Disastrous Investigative Misstep

Recently, Advize Health was involved in a matter pertaining to some medical record audits and investigations that were ongoing with a Social Adult Day Care (SADC), located on the West Coast.  For a five year period, this SADC was the subject of audits,...