Navigating the 2024 OIG Audit Targets

Event: Live Webinar
Event Date: October 31, 2023
Presenter: Toni Elhoms
Event Time: 1 pm EST
Duration:60 Minutes

Description:

Healthcare is a multi-trillion-dollar industry that remains highly regulated. When organizations bill for services, they are reimbursed on a good-faith basis with the expectation that clinical documentation supports the services reported and regulatory compliance has been met. Every year the OIG releases its respective work plan which highlights areas and services that represent high-priority audit targets during the upcoming year. Each year the OIG releases their respective work plan which highlights areas and services that represent high-priority audit targets during the upcoming fiscal year and releases monthly updates to the work plan.

It is imperative for organizations to stay diligent and apprised of these compliance initiatives and be especially proactive in their compliance efforts, conduct regular audits of processes and clinical documentation, and comply with the mandatory self-reporting requirements set forth by the Affordable Care Act. In today’s webinar, we discuss the key governing authorities involved in healthcare compliance in 2024, pathways involved in audits and investigations, review the OIG work plan with the most recent updates, spotlight current audit trends and audit targets in 2024, identify relevant action protocols, discuss examples of the latest OIG advisory opinions, identify elements of an effective compliance plan based on recent updates, and discuss actionable best practice tips to set you up for success in 2024 and beyond.

Session Highlights:

  • Outline the governing authorities involved in overseeing and enforcing healthcare compliance in 2024
  • Review the various pathways involved in healthcare compliance audit and investigations in 2024
  • Discuss the role of the OIG Work Plan in 2024
  • Deconstruct 2024 trends and OIG audit targets in healthcare compliance
  • Discuss fee-for-service audit targets in 2024
  • Review risk-adjustment audit targets in 2024
  • Define the process of audit error rate extrapolation in 2024
  • Identify key elements of an effective compliance plan based on the OIG framework in 2024
  • Review the over-payment and voluntary refund protocols for 2024
  • Discuss when the OIG self-disclosure protocol may be appropriate
  • Review relevant and recent OIG Advisory Opinions
  • Discuss proactive compliance best practice tips for 2024

Learning Objectives

  • Understand the governing authorities involved in overseeing and enforcing healthcare compliance in 2024
  • Recall the role of the OIG Work Plan
  • Recognize 2024 trends and OIG audit targets in healthcare compliance
  • Recall overpayment and voluntary refund protocols in 2024
  • Recognize when the OIG self-disclosure protocol may be appropriate
  • Understand recent OIG Advisory Opinions

Why Should You Attend:

Today’s webinar will cover the key governing authorities involved in healthcare compliance, dissect various pathways involved in audits and investigations, review the OIG 2024 work plan, spotlight 2024 audit trends and audit targets, identify relevant action protocols, discuss recent OIG advisory opinions, identify elements of an effective compliance plan, and discuss actionable best practice tips for success in 2024.

Who Should Attend:

  • Medical Coding Specialists
  • Medical Billing Specialists
  • Medical Auditing Specialists
  • Private Practice Physicians
  • Operations Leadership
  • Practice Managers & Administrators
  • Office Managers
  • Managed Care Professionals
  • Compliance Officers/Committees
  • American Health Information Management Association
  • Medical Group Management Association
  • Health Care Compliance Association
  • Medical Associations

Toni Elhoms

Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Toni's expertise extends to both inpatient and outpatient coding, compliance, billing, and reimbursement. She serves as ACE’s Senior Consultant and conducts training and educational seminars across the country. With well over a decade of industry experience, Ms. Elhoms has led and supported hospital systems, universities, physician practices, payers, law firms, government agencies, and other entities on coding, billing, and compliance initiatives. Toni is a frequent contributor to various media outlets, a highly sought-after conference speaker, and a regular guest on industry podcasts. She frequently serves as an expert and consulting witness in both civil and criminal litigation matters. Ms. Elhoms was appointed as an editorial advisory board (EAB) member for The Coding Institute (TCI) in 2020. She created and regularly hosts the Alpha Coding Podcast series (rated a top industry podcast) to share her industry Pro-Tips. She is a regular volunteer and mentors a network of Revenue Cycle Management (RCM) and Health Information Management (HIM) professionals across the United States.