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Medical Coding News Archives

OIG Releases Fiscal 2011 Work Plan

 
October 29, 2010:
Carefully reviewing the fiscal 2011 work plan the Office of Inspector General released October 1 can help physicians identify potential compliance risks for their provider type.

The Office of Inspector General’s work plan for fiscal 2011, released October 1, describes projects the agency plans to initiate or continue to work on in the upcoming year. In addition, it addresses fiscal responsibilities and compliance programs using federal funds, including the Centers for Medicare and Medicaid Services, public health agencies, the Administration for Children and Families, and the Administration on Aging. The work plan provides a roadmap of what the government is investigating—new areas for review as well as ongoing reviews that are in the plan year after year.

Below are some of the specific areas the OIG has indicated it will focus on:

Hospitals

  • Medicare excessive payments
  • Medicare disproportionate share payments
  • Medicare outlier payments
  • Hospital readmissions
  • Hospital admissions with conditions coded as present on admission
Home Health Agencies
  • Part B payments for home health beneficiaries
  • Home health agencies’ claims for Medicare home health resource groups
  • Home health prospective payment system controls
Physician and Nonphysician Providers
  • Place-of-service errors
  • Ambulatory surgery center payment system
  • Coding of evaluation and management services
  • Payments for evaluation and management services
  • Evaluation and management services during global surgery periods
  • Medicare payments for Part B imaging services
  • Medicare Part B payments for glycated hemoglobin A1C tests
  • Trends in laboratory utilization
  • Lab test payments: comparison of Medicare with other public payers
  • Error-prone providers: Medicare Part A and Part B
  • Comprehensive error rate testing program: FY 2010 error rate oversight
  • Medicare services billed with dates of service after beneficiaries’ dates of death
Providers can view or download the work plan online at:
http://oig.hhs.gov/publications/workplan/2011/.
Deborah C. Hall
Clinical/Technical Editor
Key Terms; OIG Work Plan, Fraud, Abuse, Billing Errors, Payment Errors

 

 
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