Andrew VanLandingham

@ElliottStephenB Did you just skip over the demons?

Mae Beavers stem cells

@LauraDague @OIGatHHS There are about 10 audits related to deceased enrollees like this one: oig.hhs.gov/oas/reports/re…. And this audit covers individuals enrolled in two states: oig.hhs.gov/oas/reports/re…

@vanman0254 @OIGatHHS thank you Andrew! is there a public report you have in mind you are able to connect me with?

IMO some nuance is missing from current conversations around TX Medicaid redeterminations. (Thread)

@LauraDague We at @OIGatHHS found several issues in our audits that demonstrate this problem. States paying MCOs for deceased enrollees & enrollees that have moved out of state and now covered by another plan. Those are pretty straight forward problems that are eligibility adjacent.

As states have moved to these contracts, it matters a lot more for costs whether an individual counts as enrolled when they aren't actually using any health care services. Maybe this gets incorporated into contracting and maybe it doesn't, would love to see research on that.

New Report: HHS-OIG found that #Medicaid #managedcare organizations (MCOs) denied 1 out of 8 prior authorization requests for services, several MCOs had denial rates higher than 25%, and most states’ oversight of these denials was limited. direc.to/fgxu

@HealthPrivacy @healthapiguy @lisabari @OIGatHHS We will investigate health care providers once HHS establishes the disincentives. For more specific info, stay tuned to the HHS provider disincentives rule currently in development. But generally, priorities in OIG’s recent final rule are consistent across all of our authorities.

@vanman0254 @healthapiguy @lisabari @OIGatHHS thanks, @vanman0254 Isn't OIG responsible for investigating provider actors (w/referral to HHS for disincentive penalties)? Some parts of the rule seem relevant to investigations prior to penalty phase (eg, enforcement priorities). So a separate rule on provider investigations?

Hot off the presses! #InformationBlocking (sharing??) enforcement is finalized from @OIGatHHS oig.hhs.gov/reports-and-pu…

@HealthPrivacy @healthapiguy @lisabari @OIGatHHS Sorry, did not apply to the provider disincentives.

@HealthPrivacy @healthapiguy @lisabari @OIGatHHS That’s not quite right. The due process and appeals pieces of the rule are specific to the civil monetary penalities that only apply to health IT developers and HIN / HIEs. All of that was specifically established in the Cures Act and it did apply to the provider disincentives.

@HITpolicywonk @lisabari @healthapiguy @OIGatHHS @ONC_HealthIT Also, as the rule explains, we will use the complaints to see if there is a pattern of conduct that raises concerns. Even if those complaints were made prior to the rule’s effective date, they will help inform what allegations we prioritize to investigate.

@HITpolicywonk @lisabari @healthapiguy @OIGatHHS If a complaint was made to @ONC_HealthIT or @OIGatHHS prior to the rule’s effective date, it still may warrant investigation. We may follow up with complainant to see if the conduct is ongoing. If conduct occurs after the rule’s effective date, then it’s subject to enforcement.

@OIGatHHS @ONC_HealthIT 7) finally, while we fully expect #infoblocking enforcement will improve interoperability in health care, it’s not the only tool. Avoid enforcement and improve the flow of data by being proactive to comply with @ONC_HealthIT rules. Don’t wait for @OIGatHHS to knock on your door.

@OIGatHHS @ONC_HealthIT 6) if you have questions about @OIGatHHS rule on #infoblocking enforcement please reach out. We may post answers to common questions on our website. If you have questions about @ONC_HealthIT info blocking definitions and exceptions continue to reach out to them.

The @OIGatHHS final rule for #infoblocking enforcement is now public. oig.hhs.gov/reports-and-pu….

@nikillinit Most frequent error was not documenting treatment time. Every time I go to therapy the practitioner says “we’re about at time.” So they already monitor the clock; it’s just about documenting it. I’m sure there are easy ways to do that, but this isn’t a crazy requirement.

@vanman0254 Appreciate the clarity - I guess it does make one wonder if the compliance measures required are feasible/too onerous or if maybe there are other passive ways to monitor this Or if I guess they assume they won’t get audited and actively decide it’s not worth their time?

OIG did an audit of psychotherapy services provided during COVID and seems that have found that $580M of the $1B paid out were done so improperly oig.hhs.gov/oas/reports/re…

User reports indicate Hulu is having problems since 4:48 PM EDT. downdetector.com/status/hulu/ RT if you're also having problems #Huludown