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Update on the OIG Report on Potential Abuse or Neglect of Patients

Posted on Tuesday, July 30, 2019 5:47 PM

Earlier this month, the OIG released “CMS Could Use Medicare Data to Identify Instances of Potential Abuse or Neglect” discussing how the OIG identified cases of abuse and neglect using diagnosis codes on claims.  OIG also found that that not all cases of abuse and neglect are reported.  In addition to this report, the OIG also recently released A Resource Guide for Using Diagnosis Codes in Health Insurance Claims To Help Identify Unreported Abuse or Neglect.

This report was created to assist partners such as State Medicare Fraud Control Units, Survey Agencies, Adult and Child Protection Service Agencies as well as compliance working in hospitals, home health and nursing homes to create their own processes to identify:

  • unreported instances of abuse or neglect;
  • beneficiaries or patients who may require immediate intervention to ensure their safety;
  • providers exhibiting patterns of abuse or neglect; and
  • instances in which providers did not comply with mandatory-reporting requirements.

Source: NAHC Report


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