State Medicaid agencies fail to report inadequate providers to OIG
Healthcare Auditing Weekly, August 19, 2008
An OIG report shows states continually fail to inform the OIG when they prohibit healthcare providers from Medicaid programs for incompetence, fraud, or abuse.
Federal law requires states to report deficient providers to the OIG so the OIG can include the providers on its reimbursement exclusion list. Not following this law makes it easy for these providers to set up services in a different state and/or continue to receive reimbursements from the Medicaid program.
The OIG found that 61% of the 4,319 sanctions imposed by state Medicaid agencies in 2004 and 2005 were not on the federal list. Several state officials said they were uncertain about the kind of information they were required to provide to the OIG.
The agency will “strive to reduce the barriers that may currently exist” I order to increase the number of referrals from states, said CMS spokesperson Jeff Nelligan in a San Francisco Chronicle article.
Comments
0 comments on “State Medicaid agencies fail to report inadequate providers to OIG ”
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Level of encryption needed for email
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Q&A: Acute respiratory failure diagnosis does not require intubation
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- Oxygen Cylinder Storage Requirements
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Understand the spine to code back procedures correctly
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Searched