The Cost of Noncompliance
Published December 6, 2016
The Cost of Noncompliance
Source: Provider Trust
The Office of Inspector General (OIG) has many responsibilities, including conducting audits with the Coordinated Healthcare Task Force and their continued areas of concern. Each year, these audits result in hundreds of thousands of dollars in fines for noncompliance.
So far in 2016:
Exclusions
- The OIG excluded 65,797 individuals and entities
- 2970 entities and 62,826 individuals
Civil Fines and Monetary Penalties
- 56 fines have been issued for a total of $7,201,781, averaging $128,603 per fine.
Coordinated Healthcare Task Force Enforcements
In 2016, The HEAT Strike Forces continued its coordinated efforts of working with law enforcement, DOJ, FBI and CMS to target and prosecute fraud and abuse in healthcare. There are nine core cities where these HEAT Strike Forces have set up shop.
Specific areas that the OIG has expressed continued concern are cases involving fraud and abuse related to:
- Controlled and non-controlled prescription drugs
- Home health agencies, personal care, and home and community based services
- Ambulance Transportation
- Durable medical equipment
- Diagnostic Radiology and Laboratory testing
- False Claims and Billings
- Quality of Care
- Assisting Medicaid Fraud Control Units (MFCU) in investigations
- Payments made for services after a person is deceased, and
- Organized crime activity in healthcare fraud