Compliance Officers Governance Overpayments 
YouCompli
MARCH 22, 2023
There has been significant enforcement over the last couple years relating to overpayments for UDT. Department of Health and Human Services Office of Inspector General (OIG) has expressed concerns about UDT billing. The overpayment rate for definitive drug testing for 22 or more drug classes was over 71%.
Health Law Advisor
AUGUST 25, 2023
In July 2022, the New York State Office of the Medicaid Inspector General (“OMIG”) proposed extensive modifications to the regulatory requirements governing compliance programs for entities receiving “significant” Medicaid revenue (increased by these regulations from a threshold of $500,000 to $1 million).
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AIHC
FEBRUARY 17, 2025
There are also self-reporting mechanisms in place to report overpayments on the OIG website ( Self-Disclosure ) and Self-Referral Disclosure for voluntary self-reporting of overpayments on the Centers for Medicare and Medicaid Services (CMS) website. Could it result in the cobra effect (explained further below).
Healthcare Law Blog
FEBRUARY 3, 2023
New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.
C&M Health Law
DECEMBER 18, 2023
Compliance policies should be developed under the direction and supervision of the compliance officer and compliance committee and should address the implementation and operation of an entity’s compliance program and processes. OIG’s updated take on the seven elements is briefly summarized below. (1)
YouCompli
FEBRUARY 22, 2023
Compliance officers can help protect revenue and reduce the risk of penalties by collaborating with the Finance and Reimbursement departments to navigate the dynamics of outlier payments and prospective repayment. The government alleged these increased charges resulted in the greater number of outlier payments.
YouCompli
NOVEMBER 1, 2023
As compliance officers, we are continually placed in a position to influence the actions of others and help shape our organization’s compliance culture. One way to change that perception is to avoid creating “gotcha” moments when you’re working on a compliance-related matter.
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