The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) released its revamped Semiannual Report (SAR) on June 3, 2024. The SAR’s new format focuses on the oversight work OIG completed during the reporting period, and emphasizes how this work directly addresses the Top Management Challenges Facing HHS. The SAR contains valuable information and insights for providers into those areas on which OIG and its law enforcement partners will focus in the remainder of this calendar year such as:
- Ensuring access to behavioral health services and treatment for opioid disorder, while simultaneously ramping up exclusions for opioid-related drug diversion;
- Continuing to aggressively pursue cases against those engaged in COVID-19-related fraud;
- Reducing improper payments in Medicare and Medicaid related to unnecessary genetic tests, durable medical equipment that patients did not need, and home health therapy services or telemedicine visits that never occurred; and
- Prosecuting and/or excluding those who provide substandard care or who abuse and neglect patients in nursing homes and in other care settings.
The revamped SAR now includes five appendices that provide detailed information on OIG’s oversight, including a full list of audits and evaluations it issued to each HHS operating division during the reporting period (October 1, 2023-March 31, 2024). Finally, in this SAR, OIG renewed its call for greater provider input to its annual proposals to develop new (or modify existing) safe harbors to the Federal Anti-Kickback statute and its special fraud alerts.
Each SAR that OIG issues is an invitation and a reminder to providers that they should perform periodic evaluations to identify their specific risk areas, assess the effectiveness of their compliance programs, and make any necessary adjustments.
A copy of the complete Semiannual Report can be found at: https://oig.hhs.gov/documents/sar/9905/Spring_2024_SAR.pdf
Should you have any questions regarding the above, please contact the authors, the Garfunkel Wild attorney with whom you regularly work, or contact us at [email protected].