OIG Releases Updated Guidance on IRO Independence and Objectivity for Performing Corporate Integrity Agreement Reviews

The U.S. Department of Health and Human Services Office of Inspector General (OIG) released today, August 24, 2016, an updated guidance on the OIG’s views on the applicable independence and objectivity standards for Independent Review Organizations (IROs) that perform reviews required under Corporate Integrity Agreements (CIAs), such as claims reviews and cost report reviews. The OIG has previously issued guidance in 2004 and 2010 to reflect updated standards and the additional types of IRO reviews included in CIAs. This OIG guidance released today is to reflect the 2011 revisions to the GAO accounting standards. Continue reading

Anesthesia Group Settles Kickback Allegations to Obtain Exclusive Agreements With Ambulatory Surgery Centers

On August 5, 2016, the United States Attorney for the Middle District of Georgia announced a civil settlement in which Sweet Dreams Anesthesia, a partnership of certified registered nurse anesthetists (CRNAs), paid over $1,015,000 to resolve allegations that Sweet Dreams paid kickbacks to ambulatory surgery centers to induce Medicare and Medicaid patients by providing free anesthesia drugs and through other financial transactions. Continue reading