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Thursday, 11 November 2010
Sherry Krueger

Healthcare Compliance Alert

Written by  Sherry Krueger

**ALERT ** ALERT ** ALERT**

The office of Inspector General (OIG) has released its “2011 Workplan”. In other words, these areas of compliance are going to be targeted for audit (and fined accordingly, I’m sure).

The areas of specific focus for physicians / medical practices are:


Place of Service Errors
Ambulatory Surgical 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
Billing of Portable X-Ray Supplies
Outpatient Physical Therapy Services Provided by Independent Therapists
Questionable Billing for Medicare Outpatient Therapy Services
Appropriateness of Medicare Payments for Polysomnography
Medicare Payments for Sleep Testing
Excessive Payments for Diagnostic Tests
Medicare Part B Payments for Glycated Hemoglobin A1C Tests
Trends in Laboratory Utilization
Geographic Areas with a High Density of Independent Diagnostic Testing Facilities
Independent Diagnostic Testing Facilities’ Compliance with Medicare Standards
Medicare Providers’ Compliance with Assignment Rules
Medicare Payments for Claims Deemed Not Reasonable and Necessary
Medicare Billings with Modifier GY
Payments for Services Ordered or Referred by Excluded Providers
Payments for ESRD Beneficiaries Entitled to Medicare Under Special Provisions
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
For a copy of the entire 2011 Workplan visit http://oig.hhs.gov/publications/workplan/2011/

 
Share This entry was posted on Thursday, November 11th, 2010 and is filed under Regulatory Compliance. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site.
1 Comment
#1 by Chris Carraway, DC on November 24th, 2010

Quote

I read in a CMS paper that they are getting back $3.75 for every $1.00 they spend on record audits. I’d like and investment that yielded a return like that.

Last modified on Tuesday, 17 May 2011

Sherry Krueger

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