Lewis Morris, the chief counsel to HHS Inspector General Dan Levinson, is retiring April 1 from OIG after 25 years. Morris has been integral to the expansion of OIG’s compliance guidance and enforcement activities. He also is a former special assistant U.S. attorney and board member of the Health Care Compliance Association and American Health Lawyers Association. He will be replaced by Gregory Demske, who has been assistant inspector general for legal affairs since 2005. “Lew has been in this... Read more

By now, most people probably know that HHS has delayed the October 2013 implementation date of ICD-10 diagnosis and procedure codes. While HHS apparently responded to concerns raised by some sectors of the industry, the jury is still out on whether the delay will serve providers well. On the one hand, the transition to ICD-10 can be overwhelming, and the delay helps providers ease into it. On the other hand, many organizations have been preparing for it and have already invested in adapting to... Read more

There’s been no shortage of hospital civil monetary penalty (CMP) settlements for alleged Stark and kickback violations, most of them stemming from self-disclosures. The HHS Office of Inspector General rolled out a number of them in late December, and the settlement amounts aren’t small potatoes. For example, Westfields Hospital in Wisconsin agreed to pay $204,150 to resolve allegations that it violated the CMP law in connection with providing space, services and supplies to four physician... Read more

Employment of excluded people continues to pose a significant compliance risk, judging by the latest round of civil monetary penalty settlements announced by the HHS Office of Inspector General on Dec. 16. All seven CMP settlements for false and fraudulent claims — as opposed to the CMP settlements for patient dumping or Stark and kickback violations — stemmed from the employment of individuals that health care organizations “knew or should have known were excluded from participation in federal... Read more

Evaluation and management (E/M) services are a hot topic on the HHS Office of Inspector General’s 2012 Work Plan, reflecting past audits that identified errors in this area and the growing use of electronic health record (EHR) documentation shortcuts, which open the door to compliance problems. The OIG’s Office of Audit Services or the Office of Evaluations and Inspections will tackle these four aspects of E/M services: (1) Evaluation and Management Services: Trends in Coding of Claims, (2)... Read more

Sometimes when providers settle fraud cases, they decline to enter into corporate integrity agreements. Now the HHS Office of Inspector General wants to know whether these providers are conforming to Medicare, Medicaid and other federal statutes, regulations and written directives in the absence of CIAs. So the OIG 2012 Work Plan will review entities that refused CIAs in their settlements. “OIG reviews may be similar to or more extensive than those that would be performed by Independent Review... Read more

An intriguing case has come out of the U.S. attorney’s office in Wheeling, W. Va. Ohio Valley Health Education & Services Corp., Ohio Valley Medical Center and East Ohio Regional Hospital have agreed to pay $3.8 million to settle Medicare and Medicaid false claims allegations stemming from violations of the Stark law from January 2005 to August 2010, U.S. Attorney William J. Ihlenfeld II, from the Northern Judicial District of West Virginia, announced Sept. 12. “The compensation... Read more

CMS is working on an update to the hospital conditions of participation (CoP) and will address its authentication requirement for physician orders. CMS requires physicians to authenticate verbal orders, which means the physician who gave the verbal order must date, time and sign it within 48 hours, according to the 2007 CoP update, which appeared in the Nov. 27, 2006, Federal Register. (There was one exception: Another physician responsible for the care can authenticate the original physician’s... Read more

The chief counsel to HHS Inspector General Dan Levinson revealed more about the OIG's new hospital audit strategy - Medicare compliance reviews - in July 12 testimony on Capitol Hill. During Medicare compliance reviews, OIG auditors review numerous risk areas at a hospital at the same time. In the past, auditors focused on only one risk area. "We test hospitals against 27 risk areas that our prior audit and enforcement experience indicate are error-prone," Lewis Morris said before the U.S.... Read more