ARTICLE
On November 14, 2019, the Office of Inspector General (OIG) announced a new way for the public to file a complaint when they suspect fraud, waste, or abuse. New changes to the website have made it more user-friendly to file a complaint. The site even offers the option to report anonymously or to identify yourself as a whistleblower. The OIG receives nearly 115,000 complaints each year. In the promotional video announcing this new change, the OIG stated these complaints have led to thousands of referrals for further action. The new website includes a section titled, “What You Need to Know.” Complainants can review this section to see what types of claims the OIG investigates and which ones are handled by other government agencies. It also provides additional information needed when making a complaint. This new and improved reporting system also provides the added benefit of providing even more detailed information on complaints than the OIG had previously received. For years, we have heard that the Office of Inspector General (OIG) is cracking down on healthcare fraud, waste, and abuse. The OIG began issuing reports with concerns about overpayments for chiropractic services as early as 2001 and as recently as 2018. In 2018, the OIG stated that chiropractic had the highest rate of improper payments (2010 through 2015) ranging from 43.9% to 54.1% compared with 9.9% to 12.9% for all other Part B services. (OIG, 2019) It surprises me the number of providers who continue to look for "workarounds" for Medicare policies in their office. The bottom line is that Medicare and the OIG expect you, as a provider who treats Medicare patients, to know the law. And you can’t just interpret the rules to fit your desired office policies and procedures. As one provider recently learned, it can be costly when you fail to follow the rules. On August 30, 2019, the OIG published a report on the latest chiropractic office that was audited. This doctor was ultimately fined $317,038 for just $1,680 in services billed to Medicare. (Office of Public Affairs OIG, 2019) With the new simplicity of allowing consumers to notify the OIG of potential fraud, it will come as no surprise to see an increase in audits and measures taken by the OIG to up their investigative game. Thinking that it won't affect can be costly and is in essence sticking your head in the sand. Now is the time to be sure that your documentation, coding, and billing procedures are in compliance with the rules and regulations. Not sure where your practice stands? In less than five minutes, you can answer 8 simple questions to find out exactly which aspects of your financial policies may have you inadvertently exposed to potential complaints, audits, fines, and penalties. You will receive an email with: A personalized confidential report on your greatest areas of risk based on YOUR responses. A specific grade assessment of your current vulnerabilities. A clear explanation of WHY you may be at risk. Detailed steps you can take IMMEDIATELY to minimize your risk. Request your Risk Assessment Score by January 10, 2020 and win one of ten copies of the Medicare Playbook for Chiropractic, authored by Dr. Scott Munsterman, Dr. Tim Wakefield, and healthcare attorney and chiropractor, Dr. Steve Conway. By applying the very simple and understandable procedures outlined in this comprehensive manual, Chiropractors will have greater success in managing documentation standards per Medicare policy and the Medicare payment system. Click here to request your Risk Assessment Score (RAS) today!
On November 14, 2019, the Office of Inspector General (OIG) announced a new way for the public to file a complaint when they suspect fraud, waste, or abuse. New changes to the website have made it more user-friendly to file a complaint. The site even offers the option to report anonymously or to identify yourself as a whistleblower. The OIG receives nearly 115,000 complaints each year. In the promotional video announcing this new change, the OIG stated these complaints have led to thousands of referrals for further action.
The new website includes a section titled, “What You Need to Know.” Complainants can review this section to see what types of claims the OIG investigates and which ones are handled by other government agencies. It also provides additional information needed when making a complaint. This new and improved reporting system also provides the added benefit of providing even more detailed information on complaints than the OIG had previously received.
For years, we have heard that the Office of Inspector General (OIG) is cracking down on healthcare fraud, waste, and abuse. The OIG began issuing reports with concerns about overpayments for chiropractic services as early as 2001 and as recently as 2018. In 2018, the OIG stated that chiropractic had the highest rate of improper payments (2010 through 2015) ranging from 43.9% to 54.1% compared with 9.9% to 12.9% for all other Part B services. (OIG, 2019)
It surprises me the number of providers who continue to look for "workarounds" for Medicare policies in their office. The bottom line is that Medicare and the OIG expect you, as a provider who treats Medicare patients, to know the law. And you can’t just interpret the rules to fit your desired office policies and procedures. As one provider recently learned, it can be costly when you fail to follow the rules. On August 30, 2019, the OIG published a report on the latest chiropractic office that was audited. This doctor was ultimately fined $317,038 for just $1,680 in services billed to Medicare. (Office of Public Affairs OIG, 2019)
With the new simplicity of allowing consumers to notify the OIG of potential fraud, it will come as no surprise to see an increase in audits and measures taken by the OIG to up their investigative game. Thinking that it won't affect can be costly and is in essence sticking your head in the sand.
Now is the time to be sure that your documentation, coding, and billing procedures are in compliance with the rules and regulations.
Not sure where your practice stands? In less than five minutes, you can answer 8 simple questions to find out exactly which aspects of your financial policies may have you inadvertently exposed to potential complaints, audits, fines, and penalties.
You will receive an email with: