Oig Seeks Increased Funds For Health Care Fraud Detection

By Author: Jaun Paul
Total Articles: 53
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Over the past year, the OIG has been on a roll, with no intentions to slow down anytime soon. To help its efforts, the agency has requested an additional $41.5 million from the 2011 federal budget.


The OIG has asked for $324 million in funds for 2011, including $25 million more to continue oversight of Medicare and Medicaid activities previously funded through mandatory appropriations and $40 million in additional funding to train eyes on preventing health care fraud and enforcing current anti-fraud laws around the country through HEAT initiative.


By ending mandatory funding for oversight of Medicaid activities, the OIG will save $25 million from the 2011 budget as authority for this funding ends towards the end of financial year 2010.


The OIG's budget hike will certainly incite fear in many practices. But physician practices shouldn't worry about the additional scrutiny unless you are doing something wrong.


Since for every dollar they put into ...
... enforcement the government gets multiple back, it is just good business on the government's part to increase enforcement funding to curb health care fraud. Practices have been wary about the hike in funding but if you are not doing anything wrong, you can rest assured.


What needs to be done: Every practice should have the right compliance procedures in place and be careful of what they are up to. You should see to it that your staff is properly trained and that you do not upcode or bill for unnecessary services because if you are an outlier right now, that will cause the payer to look at you more carefully. See to it that you document whatever services you perform because even if you bill for the services you provide and you don't document those services in the correct manner, you could be in trouble.

Provides weekly digest newswire about compliance procedures in healthcare industry, and offers advanced Learning Opportunities about health care fraud for healthcare executives and physician billers according to 2010 Work Plan.