OIG Encouraging Providers to Self-Report Overpayments

OIG recently published the following article on its website which we thought to republish here along with the PDF documents linked to in the article.

Texas providers encouraged to self-report overpayments

Providers continue to participate in the OIG’s self-report process, choosing to collaborate to reduce fraud, waste and abuse. By participating in the process, providers potentially reduce their legal and financial exposure for billing errors submitted to the state. Working with the OIG may also increase providers' understanding of the OIG's audit and investigatory processes. The OIG recently published an easy-to-follow guide to educate providers about the self-report process. Click here to learn more (PDF below).

The following are examples of self-reported cases during the third quarter:

  • The OIG settled a case in March with a Richardson home health care provider who, through an internal investigation, discovered that a caregiver employee billed for services not rendered between August and November 2021. The provider correctly reported that it owed the Medicaid program $2,010 and agreed to repay the overpayment.
  • In May, the OIG settled a self-reported case with a hospital in Beaumont. This case involves incorrectly billing for injections and infusions separately when emergency room service charges include the procedure. The provider worked collaboratively with OIG Litigation to negotiate a final settlement of $8,738.

To learn more about self-reporting, read the OIG self-report protocol (PDF below) for an expanded explanation of the process.

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