What is an oig advisory opinion?
An Office of Inspector General (OIG) advisory opinion is a legal opinion issued by OIG to one or more requesting parties about the application of the OIG’s fraud and abuse authorities to the party’s existing or proposed business arrangement.
What is the federal Anti Kickback Statute?
The AKS is a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs (e.g., drugs, supplies, or health care services for Medicare or Medicaid patients).
What is Medicare safe harbor?
The safe harbor regulations define payment and business practices that will not be considered kickbacks, bribes, or rebates that unlawfully induce payment by Medicare or Medicaid programs. The regulations specify allowable financial and referral relationships between physicians or other providers and suppliers.
Can hospitals write off Medicare deductibles?
Like many private insurance plans, the Medicare program includes a cost-sharing requirement. However, there are two important exceptions to the general prohibition against waiving Medicare coinsurance and deductibles applicable to hospitals, one for financial hardship situations and one for inpatient hospital services.
How long are advisory opinions?
Advisory Opinion Processing Time It usually takes around 4 to 6 weeks for the Waiver Review Division to scrutinize all submitted documents and arrive at a final decision. This is excluding the time required for the mail delivery to happen both ways.
What is the OIG Work Plan?
The Work Plan The OIG Work Plan sets forth various projects including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of Evaluation and Inspections. Some Work Plan items reflect work that is statutorily required.
Is Anti-Kickback a statute?
The federal Anti-Kickback Statute (AKS) (See 42 U.S.C. § 1320a-7b.) is a criminal statute that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of business reimbursable by federal health care programs.
What is the purpose of the safe harbor Act?
Safe Harbor laws ensure that trafficked children are treated as victims, not criminals, and provide access to medical care, safe housing, remedial education, and counseling services.
Which of the following is necessary to qualify for the safe harbor provision?
To qualify for safe harbor protection, the sale must be completed within three years, and the hospital must engage in good faith efforts to recruit a new practitioner.
Are there any recommendations not closed by the OIG?
Recommendations Not Closed by the OIG as of September 30, 2019 November 26, 2019 Investigative Summary: Findings that an Employee of a Contractor for the Federal Bureau of Prisons Suffered Reprisal for Making a Protected Disclosure in Violation of Federal Law Protecting Contractor Whistleblowers Nove
Where can I find OIG voluntary compliance guidance?
OIG has developed a series of voluntary compliance program guidance documents directed at various segments of the health care industry, such as hospitals, nursing homes, third-party billers, and durable medical equipment suppliers, to encourage the development and use of internal controls to monitor adherence to applicable…
Where can I find opinions from 40 op.o.l.c?
The individual opinions from 40 Op. O.L.C. (2016), as they will soon appear in print, are available on the Opinions by Date and Title page. Volume 40 comprises five opinions previously published online in slip form, as well as the following two opinions not previously published online:
When is the audit of the Office of justice programs?
January 9, 2020 Audit of the Office of Justice Programs Office for Victims of Crime Award to Pennsylvania State University, State College, Pennsylvania, Audit Report 20-021 — Summary| Full Report Jan
What does the Office of Inspector General ( OIG ) mean?
The Office of Inspector General (OIG) expressed its interpretation of “inexpensive” or “nominal value” to mean a retail value of no more than $10 per item or $50 in the aggregate per patient on an annual basis, and noted that it would periodically review these limits and adjust them according to inflation, if appropriate.
What does it mean to be on the OIG exclusion list?
This includes “any items or services furnished, ordered or prescribed by an excluded individual or entity.” And this prohibition extends to the excluded person, the employer or anyone who employs or contracts them, including a hospital or other provider, regardless of who submits the claims.
What are the major concerns of the OIG?
OIG Significant Concerns The OIG has identified areas of significant concern that cause the Department to be at particular risk of fraud, mismanagement, waste, deficiencies, or abuse.
What does remuneration mean in the OIG Act?
For purposes of section 1128A(a)(5) of the Act, the statute defines “remuneration” to include, without limitation, waivers of copayments and deductible amounts (or any part thereof) and transfers of items or services for free or for other than fair market value.