Office of Inspector General (OIG)
OIG What’s New
http://www.oig.hhs.gov/w-new.asp
OIG Work Plan
http://www.oig.hhs.gov/publications/workplan.asp
Advisory Opinions
http://www.oig.hhs.gov/fraud/advisoryopinions/opinions.asp
Corporate Integrity Agreements
http://www.oig.hhs.gov/fraud/cias.asp
Criminal and Civil Enforcement Actions
http://www.oig.hhs.gov/fraud/enforcement/criminal/
Medicaid Fraud Control Units (MFCUs)
http://www.oig.hhs.gov/fraud/mfcu/
State Enforcement Actions
http://www.oig.hhs.gov/fraud/enforcement/state/
Office of Medicaid Inspector General (OMIG)– New York
http://www.omig.ny.gov/data/content/blogsection/31/246/
Health Care Fraud Prevention and Enforcement Team (HEAT)
http://www.stopmedicarefraud.gov
Centers for Medicare & Medicaid Services (CMS)
Comprehensive Error Rate Testing (CERT)
http://www.cms.gov/cert/
Payment Error Rate Measurement (PERM)
http://www.cms.gov/PERM/
Medicare Program Manuals
http://www.cms.gov/manuals/
Medicare Conditions of Participation
http://www.cms.gov/CFCsAndCOPs/
Comprehensive Medicaid Integrity Plan (MIP)
http://www.cms.gov/DeficitReductionAct/02_CMIP.asp#TopOfPage
Medicaid Integrity Contractors (MICs)
http://www.cms.gov/ProviderAudits/
Medicaid Integrity Institute (MII)
http://www.justice.gov/usao/eousa/ole/mii/
Medicare Administrative Contractors (MACs)
https://www.cms.gov/MedicareContractingReform/
Quality Improvement Organizations (QIOs)
http://www.qualitynet.org/dcs/ContentServer?pagename=Medqic/MQGeneralPage/GeneralPageTemplate&name=QIO%20Listings
Program for Evaluating Payment Patterns Electronic Report (PEPPER)
http://www.pepperresources.org/
Recovery Audit Contractors (RACs)
Region A – http://dcsrac.com
Region B – http://racb.cgi.com
Region C – www.connollyhealthcare.com/RAC
Region D – http://racinfo.healthdatainsights.com
Zone Program Integrity Contractors (ZPICs)
Zone 1 – N/A
Zone 2 – http://www.csc.com/advancemed/ds/11859/56878-zpic_zone_2
Zone 3 – N/A
Zone 4 – http://www.healthintegrity.org/index.html
Zone 5 – http://www.csc.com/advancemed/ds/11859/37833-zpic_zone_5
Zone 6 – N/A
Zone 7 – http://www.safeguard-servicesllc.com/zpic.asp
Office for Civil Rights (OCR)
http://www.hhs.gov/ocr/privacy/index.html
Case Examples & Resolution Agreements
http://www.hhs.gov/ocr/privacy/hipaa/enforcement/examples/index.html
View List of Breaches Affecting 500 or More Individuals
http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html
Health Care Compliance Association
http://www.hcca-info.org/
HIPAA Collaborative of Wisconsin
http://www.hipaacow.org/