The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services (HHS) continues to offer valuable insights to the healthcare industry as to how best to approach increasingly complex healthcare fraud and abuse issues. Bass, Berry & Sims is pleased to share this HHS-OIG Year In Review (HHS-OIG YIR) that highlights key guidance OIG issued in 2022, as well as other items of import involving the agency.
Our intention is not to exhaustively cover every bit of guidance OIG published last year. Rather, we have used our decades of collective experience inside and outside OIG to focus on the items we think are of the greatest importance to the healthcare industry.
In this HHS-OIG YIR, we discuss the following topics:
- Significant changes to the advisory opinion process as well as several noteworthy advisory opinions.
- OIG’s Special Fraud Alert warning against the dangers of fraudulent telehealth arrangements.
- Provisions of legislation through which Congress established a new exception for physician wellness programs and directed OIG to study contingency management interventions.
- Implications of some process updates to OIG’s self-disclosure protocol (SDP) and some noteworthy SDP settlements.
- Pfizer’s efforts to obtain a favorable advisory opinion and its subsequent attempts to convince federal courts to overturn OIG’s unfavorable advisory opinion.
- Key personnel changes at OIG.
- Although it occurred in early 2023, we mention OIG’s expanded informal FAQ guidance process for questions related to the AKS and other authorities.
We hope that this HHS-OIG YIR will assist you in understanding and determining how best to navigate fraud and abuse issues in an increasingly complex environment.