American Academy of Professional Coders (AAPC) Practice Exam

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What is the primary role of the OIG?

A government agency protecting health program integrity
A regulatory body enforcing health insurance laws
A consumer protection agency for medical services
An organization promoting healthcare innovation

The correct answer is: A government agency protecting health program integrity

The primary role of the Office of Inspector General (OIG) is to protect the integrity of health programs, such as Medicare and Medicaid. The OIG is part of the U.S. Department of Health and Human Services (HHS) and is tasked with preventing fraud, waste, and abuse within these programs. This involves conducting audits, investigations, and inspections to ensure compliance with legal and regulatory requirements. The agency also educates stakeholders about compliance and oversees programs to promote accountability and integrity in the delivery of healthcare services. Understanding the OIG's function is crucial for healthcare professionals and coding specialists, as it directly impacts how services are billed and reimbursed. Compliance with OIG regulations is vital for maintaining program integrity and avoiding potential legal issues, thereby emphasizing the importance of this agency in the healthcare landscape.