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/