Healthicity Blog

1. Attorney General Josh Stein Announces Sentencing In Fayetteville/Raeford Medicaid Fraud Case –

We talk a lot about the OIG. So much so that we use the term “OIG” to generally mean the OIG for the Federal Department of Health and Human Services. It is important to stay on top of the Federal OIG work plan, audits, investigations and other initiatives.

For those of you unfamiliar with coding and billing, modifier -59 is a two-digit numeric code modifier that can be appended to a CPT or HCPCS procedure code, for example, and will frequently bypass many payor edits.

1. Surgery center says 34,000 patient records potentially breached - “St. Mark’s Surgery Center was hit by a ransomware attack that may have impacted the personal health information of 33,877 patients.

Many compliance programs rely on the OIG Work Plan when planning their own internal audit or compliance activities. Historically, the OIG Work Plan was updated annually. However, recently the OIG has been publishing periodic updates and additions more often.

The OIG recently released their 2017 work plan. And the information is crucial for the success of your organization and compliance program.

Each year, the HHS OIG publishes a work plan which highlights areas they will focus their auditing and investigative resources upon. Some of the projects are continuations from the prior year’s work plan while some are new or revised.