Revenue Cycle

OIG illustrates five principles of compliance

Health Care Auditing Strategies, June 1, 2009

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Although the government is cutting back on many programs while the recession continues, U.S. Department of Health and Human Services (HHS) Inspector General Daniel Levinson wants compliance officers to know healthcare compliance funding is not going away. With a generation of baby boomers getting ready to sign up for Medicare, the OIG is gearing up to increase its oversight of the program and diminish Medicare fraud.
“We need to grow and figure out how we’re going to handle that enormously large portfolio,” Levinson said.
Many officials in Congress want to know what they can do to reduce fraud, waste, and abuse in healthcare, he said. To combat the problem and help others in government understand what the OIG is doing, they created the 5-Principle Strategy for Health Care Integrity. The five principles are as follows:
1. Provider enrollment. CMS continues to suffer vulnerabilities in provider enrollment. In fact, Kim Brandt, CMS director of program integrity, quipped during her Compliance Institute speech, “If you’re alive and can fill out the form, you can get a Medicare provider number.”

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