Medicaid managed care organizations deny prior authorization requests at high rates, according to a recent report by the Office of Inspector General. Of the 115 MCOs the OIG analyzed, 12 had prior authorization denial rates above 25%.
Out of the $1 billion in Medicare payments to providers for psychotherapy services in the first year of Covid-19, $580 million were improper payments, an audit by the Office of Inspector General found. This includes $348 million for telehealth services.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
Medicare could have saved $128 million if the Centers for Medicare and Medicaid Services had the correct controls in place to avoid duplicate payments with the Veterans Health Administration, an audit by the Office of Inspector General found.
Hospitals, clinics, nursing homes and other providers collected billions in government aid during the pandemic. Federal auditors may soon come knocking to ensure the money was spent correctly.
What's interesting in this special fraud alert and what was somewhat new is the dual emphasis on marketing and clinical decision making.
Hospitals reported rotting masks, weeklong waits for test results, and other challenges hampering their response to Covid-19 in a report released Monday by HHS’ Office of Inspector General.
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
Curbing the opioid epidemic, improving care for vulnerable populations and keeping HHS data safe from cybersecurity threats are all issues outlined in the 48-page report.
The OIG report describes a range of rip-offs, some of which involve caretakers caught up in the nation’s opioid epidemic.
New Wave of Meaningful Use Audits Launched by the Office of the Inspector General (OIG) Most of us have gotten pretty used to the Meaningful Use (MU) audits being conducted by Figliozzi & Company. They are the folks that have been conducting the CMS EHR Incentive audits for both eligible hospitals (EH) and professionals (EP) […]
by Tom Hess and Simi Botic On Jan. 8, 2014, the Office of Inspector General (“OIG”) updated the List of Excluded Individuals and Entities (“LEIE”). According to the LEIE, over 66,000 health care providers are currently excluded from all Federal health care plans. Health care providers receiving funding from Federal health care programs must determine […]
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.