The Office of the Inspector General (OIG) of the Department of Health and Human Services has two main tools it uses to oversee the care provided by hospitals and other providers: their Work Plan and their audits. If providers don’t stay abreast of the constantly changing Medicare rules and often complicated and contradictory guidance, they could end up being a target of an OIG investigation.

During this timely RACmonitor webcast, Ronald Hirsch, MD, FACP, ACPA-C, CHRI, will spotlight the areas of the OIG’s Work Plan and the finding of their most recent audits that impact utilization review, case management, and audit staff. He’ll also provide his inimitable common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.

Why This Is Relevant:

No provider wants to be the target of an OIG investigation. Most hospital staff don’t have the time or manpower to keep abreast of every CMS update. Yet a violation or adverse audit outcome can lead to paybacks, increased scrutiny, and on rare occasions, criminal penalties.

Learning Objectives:

• Understand the role of the OIG and the Work Plan
• Discuss recent additions to the Work Plan with the related regulations
• Review common audit findings and formulate processes to ensure compliance
• Understand the impact on utilization review, case management, and audit staff

Who Should Attend:

Staff in utilization review, case management, compliance, auditing, revenue integrity, revenue cycle, billing, and coding, as well as physician advisors.