OIG Fraud Risk Indicator

By Catherine Boerner

Catherine Boerner (cboerner@boernerconsultingllc.com) is President at Boerner Consulting, LLC in New Berlin, WI.

Have you seen the OIG’s “Fraud Risk Indicator”? It’s the figure below, which can be found on their website at https://oig.hhs.gov/compliance/corporate-integrity-agreements/risk.asp (https://bit.ly/2ImyIzw) to gain a further understanding and review the “published criteria.”

OIG assessment of future risk posed by persons who have allegedly engaged in civil healthcare fraud

Basically, OIG assigns people to the following categories , based on their criteria, when gathering information on a False Claims Act (FCA) case. OIG will use its exclusion authority differently for parties in each category.

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