An Aging Population Triggers Proliferating Oversight From The OIG

An Aging Population Triggers Proliferating Oversight From The OIG

Elder care has been a concern for the nation over the past decade, and the need for qualified personnel and reputable facilities is continuing as a high demand.  With this swelling demand, there is growing concern over the level of competence in these facilities, and the fact that the aging population may significantly drain Medicare and SSA.

With Elderly Care proving to have one of the highest rates of increase, by nearly doubling over the past five years, it has also become one of the biggest industries that the OIG is looking at in regards to reform.  This An Aging Population Triggers Proliferating Oversight From The OIGmeans that HR managers in nursing homes, hospice care, and other elder care facilities should expect to receive audits and investigation over the next year, regardless of status of practices.

Expect Increased Fines

The release of the 2015 work plan by the OIG gives employers a slightly clearer picture of what is to come.  With last year showing over 4,000 exclusions and close to 1,000 penalties, many employers have become fearful of adhering to the parameters of restriction.  However, the recovery action of this year’s plan is highly focused on rectifying best practices, and the federal fiscal gain could benefit employers who are up to code.

One of the greatest concerns appears to the increase in audits that are expected to be performed.  It should be noted that while health and safety standards are high goals for this work plan, the stronger scrutiny of the auditing process is also focused on outright fraud and poor business practices.

The fine print of over $4 billion in receivables can also be read as hefty fines and penalties for non-adherence to federal hiring regulations.  While the OIG may be more concerned with fraud and misuse of SSA and Medicare funds, exclusion violations do contribute to this drain on the national budget.

Remain Current on Screening Excluded Employees

This means that employers must remain current on exclusion screening, and develop best practices in order to avoid the possibility of a penalty.  Oversights that allow for employees who may have become excluded to remain on staff will result in hefty fines.

Automated OIG checks can provide the protection that can catch such an oversight, and it is recommended that employers stay alert to status changes.

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About Frank Strafford