Certified Inpatient Coding (CIC) Practice Exam

Which of the following activities is NOT part of the OIG's functions in healthcare?

1. Excluding individuals from Medicare participation

2. Monitoring Corporate Integrity Agreements

3. Suing facilities for malpractice

4. Assessing civil monetary penalties

The correct answer is: Suing facilities for malpractice

The correct answer is based on the primary responsibilities of the Office of Inspector General (OIG) within the healthcare sector. OIG's functions are designed to protect the integrity of federal healthcare programs, promote efficiency, and deter fraud and abuse. Excluding individuals from Medicare participation, monitoring Corporate Integrity Agreements, and assessing civil monetary penalties are all actions aligned with the mission of the OIG. For instance, the OIG has the authority to exclude individuals or entities from participating in Medicare due to various offenses, aligning with their mission to protect the integrity of the healthcare system. Monitoring Corporate Integrity Agreements ensures that organizations comply with applicable laws and regulations following identified violations or misconduct. Additionally, the OIG can impose civil monetary penalties on entities that violate healthcare laws, further emphasizing their role in maintaining compliance and accountability in healthcare practices. In contrast, suing facilities for malpractice does not fall under the OIG's responsibilities. Malpractice suits are generally matters for private legal action or state regulatory bodies rather than being within the scope of OIG's enforcement functions. Therefore, the activity of suing facilities for malpractice is clearly separate from the OIG’s designated roles, which focus more on regulatory oversight and enforcement against fraud and abuse in federal healthcare programs.