Insights & Resources

November 20, 2023 | Alerts

OIG Provides Roadmap to Hot-Button Issues

OIG Provides Roadmap to Hot-Button Issues

The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) fulfilled its annual statutory obligation by releasing its Top Management and Performance Challenges (TMC) document. The TMC document traditionally has not garnered widespread interest in the provider community because it is focused on HHS operational challenges.  Providers, however, should take note because the document provides important insight into the specific areas over which HHS (and the OIG) will remain focused.  These include longstanding areas of concern such as:

  • hospice, home health, hospital outpatient, and skilled nursing facility care;
  • durable medical equipment;
  • genetic testing;
  • treatment for substance use disorders; and
  • medical identity theft.

The TMC document also identifies emerging areas of concern such as:

  • COVID-19 test billing;
  • telehealth services;
  • high-billing labs;
  • upcoded hospital stays to increase reimbursement;
  • use of grant funds for intended purposes; and
  • scams that use social media to offer fake grants.

Accordingly, providers and other relevant stakeholders operating in these “high-risk” areas must remain vigilant.

Should you have any questions regarding the above, please contact David Traskey, the Garfunkel Wild attorney with whom you regularly work, or contact us at [email protected].