Home Health & Hospice Week

Providers that don’t want to enter into a Corporate Integrity Agreement with the OIG when asked may not realize they are going to find themselves bounced to a whole new level of oversight.

When the HHS Office of Inspector General determines that parties needed “additional oversight,” but “they refused to enter Corporate Integrity Agreements (CIAs) sufficient to protect Federal healthcare programs,” they are placed in a “High Risk Category,” the OIG details. The OIG began a list of providers in that category last year. The CIA abstainers are “subject to heightened scrutiny, because they pose a significant risk to Federal healthcare programs and beneficiaries,” the OIG says.

The OIG makes the High Risk Category providers list public, and the latest addition is a New York hospice. MJHS Hospice and Palliative Care Inc. recently paid $5.2 million to settle charges that it upcoded General Inpatient and Continuous Home Care claims (see HCW by AAPC, Vol. XXIX, No. 31). Three other providers are currently on the list at https://oig.hhs.gov/compliance/corporate-integrity-agreements/high-risk.asp.