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Fraud and Abuse

Our LeadingAge legal team offers analyses of regulations, case law and legislative developments regarding fraud and abuse issues.

We've featured some articles below, but be sure to check out all of our public policy and legal issues content.

 

Featured Content

OIG Issues Advisory Opinion No. 14-01 regarding Referrals to Senior Residential Communities

On Jan. 13, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued Advisory Opinion No. 14-01 in which it concluded that while an arrangement involving payments to a senior living placement agency would potentially generate prohibited remuneration under the Anti-Kickback Statue (AKS) if the requisite intent to induce or reward referrals of federal health care program business were present, parties to the arrangement had taken sufficient steps to adequately reduce that risk. As a result, OIG concluded that it would not subject the parties to administrative sanctions.

OIG Releases Revised Self-Disclosure Protocol

On April 17, 2013, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a substantially revised Self-Disclosure Protocol (SDP). This updated SDP supersedes and replaces the OIG's original 1998 SDP, as well as 3 Open Letters to Providers that the Inspector General issued about the SDP in 2006, 2008, and 2009. 

OIG Releases Video Podcast Regarding Board Role in Compliance Efforts

The board of a healthcare organization is critical to the organization’s compliance efforts, according to a new video toolkit from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG).

Safeguarding Medical Identity Training Course Offered by HHS OIG

The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has made available to Medicare and Medicaid providers a free 60-minute web-based training course designed to provide education to providers regarding medical identity theft.

Quality of Care Oversight in Medicaid Waiver Programs Report and Podcast from OIG

The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services has released a report and accompanying podcast detailing quality of care oversight in Medicaid Waiver programs.