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Medicaid › Nursing Homes › Office of the Inspector General

Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with... more +
Medicaid is a partnership program between states and the federal government to provide healthcare coverage for lower income individuals, people with disabilities, older people, and certain families with children.  less -
Health Care Compliance Association (HCCA)

HHS OIG’s Nursing Facility: Industry Segment-Specific Compliance Program Guidance

Health Care Compliance Association (HCCA) on

In November 2024, the Office of Inspector General at Health and Human Services released its Nursing Facility: Industry Segment-Specific Compliance Program Guidance. The document is part of an effort to modernize how HHS OIG...more

Health Care Compliance Association (HCCA)

Healthcare Industry Segment-Specific Compliance Program Guidances (ICPGs)

Health Care Compliance Association (HCCA) on

In addition to releasing its General Compliance Program Guidance, the OIG at HHS announced plans to publish a series of Industry Segment-Specific Compliance Program Guidances (ICPG). The first of these, addressing nursing...more

McDermott Will & Schulte

OIG Nursing Facility Compliance Program Guidance: Renewed Focus on Fraud and Abuse

McDermott Will & Schulte on

The US Department of Health and Human Services Office of Inspector General’s (OIG’s) release of Nursing Facility Industry Segment-Specific Compliance Program Guidance (ICPG) for the first time since 2008 reemphasizes the...more

Rivkin Radler LLP

NYS OMIG Publishes 2025 Work Plan

Rivkin Radler LLP on

On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post...more

Baker Donelson

Enhancing Compliance in Nursing Facilities: OIG's New Guidance

Baker Donelson on

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) issued new Nursing Facility Industry Segment-Specific Compliance Program Guidance (Nursing Facility ICPG) for nursing facilities...more

Arnall Golden Gregory LLP

OIG Updates Compliance Guidance for Nursing Facilities

Arnall Golden Gregory LLP on

In 1998, the Office of Inspector General (“OIG”) for the U.S. Department of Health and Human Services began issuing voluntary, compliance program guidance for various segments of the healthcare industry. Recently, the OIG has...more

Lathrop GPM

OIG Issues New Nursing Facility Compliance Guidance, Comes on the Heels of Enhanced Medicare Enrollment Requirements for SNFs

Lathrop GPM on

The Office of Inspector General at the U.S. Department of Health and Human Services (OIG) recently followed up on a 2023 commitment to supplement its General Compliance Program Guidance (GCPG) by publishing its first...more

Akin Gump Strauss Hauer & Feld LLP

The Regulatory Race Is On: The Biden Administration Sprints to Issue Key Health Policies

Akin Gump Strauss Hauer & Feld LLP on

The upcoming election, and the approaching end of the President’s four-year term, introduce additional dynamics into the agencies’ rulemaking process and even the guidance process. From now through the November election, the...more

Harris Beach Murtha PLLC

Updates Coming to OIG Compliance Program Guidance

Harris Beach Murtha PLLC on

The Department of Health and Human Services’ Office of Inspector General (“OIG”) willmodernize its Compliance Program Guidance (“CPG”) beginning at the end of calendar year 2023. The updates will be posted on the OIG website...more

Ballard Spahr LLP

HHS OIG to Review CMS Citations

Ballard Spahr LLP on

Summary - The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more

Maynard Nexsen

OIG to Audit Nursing Home Services Rendered Prior to Inpatient Hospitalizations – Four Steps to Take to Prepare for the Increase...

Maynard Nexsen on

Efforts to reduce avoidable inpatient hospitalizations among nursing facility residents have been ongoing for years. As an example of these initiatives, CMS ran a program from 2012 to 2020 focusing on long-stay long-term...more

Alston & Bird

Health Care Week in Review: HHS Declared a Public Health Emergency (PHE) for Puerto Rico Due to the Flooding

Alston & Bird on

Below is Alston & Bird’s Health Care Week in Review, which provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and congressional committee action; reports, studies,...more

Mintz - Health Care Viewpoints

New York Office of Medicaid Inspector General Proposes Regulations on Medicaid Provider Compliance Programs

Mintz - Health Care Viewpoints on

The New York State Office of Medicaid Inspector General (OMIG) published proposed regulations in the July 13, 2022 issue of the New York State Register. The proposed regulations would repeal the current Part 521 - Provider...more

King & Spalding

OIG Issues Semiannual Report to Congress

King & Spalding on

In December 2021, OIG issued its Semiannual Report to Congress (SAR) covering OIG’s activities for the reporting period of April 1, 2021 through September 30, 2021, as well as the entire Fiscal Year (FY) 2021 (October 1, 2020...more

King & Spalding

OIG Principal Deputy Inspector General Speaks at AHLA Fraud and Compliance Forum

King & Spalding on

On September 22, 2021, OIG Principal Deputy Inspector General Christi Grimm delivered a keynote speech to the American Health Law Association (AHLA) Fraud and Compliance Forum. Consistent with her remarks this spring at the...more

Oberheiden P.C.

OIG Compliance Program for Hospitals: 8 Keys to Success

Oberheiden P.C. on

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) is tasked with combating fraud under Medicare, Medicaid, and other federally funded healthcare programs. ...more

Maynard Nexsen

HHS Office of Inspector General Work Plan Update: News Items Added

Maynard Nexsen on

There are twelve OIG Work Plan updates released for July 2020, all of which are issued by the Office of Evaluation and Inspections, as well as the Office of Audit Services....more

Poyner Spruill LLP

The OIG Increases its Oversight of Skilled Nursing Facilities to Include a Review of Care for Dually Eligible Individuals

Poyner Spruill LLP on

The U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently updated its Work Plan in March 2019 to add an additional topic focusing on nursing facilities that receive Medicare and...more

Poyner Spruill LLP

Recent OIG Actions Demonstrate Increased Scrutiny of Nursing Facilities

Poyner Spruill LLP on

Recent developments by the U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) highlight the increase in scrutiny of nursing facilities. In addition to a topic added in August, the OIG...more

Poyner Spruill LLP

The OIG Updates Its Work Plan to Include Additional Focus on Nursing Facilities' Staffing

Poyner Spruill LLP on

The U.S. Department of Health and Human Services (DHHS) Office of Inspector General (OIG) recently updated its Work Plan in August 2018 to add an additional topic focusing on nursing facilities that receive Medicare and...more

Flaster Greenberg PC

It’s Important to Choose Where Hospice Is Provided

Flaster Greenberg PC on

It is understandable but unfortunate that family members frequently hesitate to broach the subject of end of life care. Instead of avoiding the subject, have a sensitive and frank discussion of hospice as a vehicle for...more

Baker Donelson

OIG April 2018 Work Plan Update

Baker Donelson on

The OIG's April 2018 Work Plan update added six new items to its active list of scheduled audits, inspections, and evaluations. The OIG indicates its intention to review beneficiary access to drugs under Part D, as well as...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

Bass, Berry & Sims PLC on

A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Baker Donelson

OIG Work Plan – September 2017 Update

Baker Donelson on

Beginning in June 2017, the OIG began making monthly Work Plan updates. These monthly updates create some practical challenges for health care providers and compliance professionals trying to make operational and compliance...more

Cooley LLP

Blog: OIG Releases September Work Plan Items; Includes Part D Sponsor Reporting of Rebates and Price Concessions to Medicare

Cooley LLP on

As we recently announced, the Office of Inspector General (OIG) is updating its Work Plan monthly rather than its previous twice-yearly publications. The September updates include 9 new Work Plan items: Federal Marketplace...more

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