Waltz Comments on $1.32 Million Stipulated Penalty Against Home Health Provider

22 June 2020 Report on Medicare Compliance News

Partner Judy Waltz was quoted in a Report on Medicare Compliance article, “DAB Affirms OIG’s $1.32M Penalty on Provider for Breaching CIA,” about a ruling by the HHS Departmental Appeals Board upholding a $1.32 million stipulated penalty against Friendship Home Healthcare Inc. of Nashville, Tenn., for failing to return overpayments identified under a corporate integrity agreement (CIA) by an independent review organization (IRO).

The size of the stipulated penalty and its support from the administrative tribunals sends a message about how seriously the OIG takes CIAs, Waltz said. “OIG is really expecting you to live up to every bit of your obligations,” she said.

If you’re under a CIA, Waltz added, it’s imperative to have faith in your IRO’s competence to review claims. The ALJ and DAB aren’t there to second-guess, or even review, the accuracy of the IRO’s overpayment determination or whether the stipulated penalty is warranted, she said.

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