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Other Issuances: CMS publishes MUEs, OIG issues annual Work Plan, and more

Medicare Weekly Update, October 7, 2008

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OIG issues report on excessive payments for inpatient services processed by National Government Services in Michigan and Wisconsin for calendar years (CY) 2004 and 2005

On October 3, the OIG released a report on high-dollar payments that National Government Services, a Medicare fiscal intermediary, made to hospitals for inpatient services for CYs 2004 and 2005. Of the 172 high-dollar payments examined by the OIG, 65 were appropriate. The remaining 107 payments included net overpayments totaling $1.6 million, of which $1.3 million for 105 payments had not been repaid at the start of the OIG’s audit.

View the OIG report.

CMS publishes Medically Unlikely Edits (MUE)

On October 1, CMS published on its Web site most of the MUE edits. CMS also updated 11 frequently asked questions (FAQs) relating to the MUEs.

View CMS’ MUE Web page.

View a related press release.

View the updated FAQs on the MUEs.

OIG issues fiscal year (FY) 2009 Work Plan

On October 1, the OIG released its Work Plan for FY 2009. The OIG’s focus areas for 2009 include provider-based status, Medicare and Medicaid DSH payments, and never events.

View the Work Plan.

CMS updates frequently asked question (FAQ) on device charges

On September 30, CMS updated a FAQ relating to charges for certain devices furnish in an outpatient setting.

How should hospital outpatient departments report device charges when they receive a full credit for a device being replaced by a more costly device? (view)

CMS issues final decision memo for thermal intradiscal procedures (TIP)

On September 29, CMS issued a final decision memo in which it determined that TIPs are not reasonable and necessary for the treatment of low back pain.

View the final decision memo.

CMS issues proposed decision memo for Heartsbreath test for heart transplant rejection

On September 29, CMS issued a proposed decision memo in which it proposed that the Heartsbreath diagnostic test is not reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act.

View the proposed decision memo.

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