Corporate Compliance

Work plan lists nine new audits and reviews for hospitals

Healthcare Auditing Weekly, October 7, 2008

The OIG released its 2009 work plan October 1, listing audits, reviews and examinations with an emphasis on quality of care related to payment.
Highlights from the work plan include oversight of EMTALA, never events, and hospital ownership of physician practices.

The 2009 Work Plan lists nine new audits and reviews affecting hospitals and 11 ongoing examinations.

The nine new Medicare hospital items include:
  • Additional Part A Medicare capital payments for extraordinary circumstances
  • Hospital ownership of physician practices
  • Inpatient hospital payments for new technologies
  • Inpatient rehabilitation facility payments
  • Inpatient psychiatric facility emergency department adjustments
  • Reliability of hospital-reported quality measure data
  • Oversight of hospitals’ compliance with the Emergency Medical Treatment and Labor Act (EMTALA)
  • Coding and documentation changes under the Medicare severity-DRG (MS-DRG) system.
  • Serious medical errors (never events)

The ongoing audits and reviews include:

  • Part A hospital capital payments
  • Provider-based status for inpatient and outpatient facilities
  • Part A inpatient prospective payment system wage indices
  • Payments to organ procurement organizations
  • Critical Access Hospitals
  • Medicare disproportionate share payments
  • Interrupted stays at inpatient psychiatric facilities payments
  • Provider bad debts
  • Medicare secondary payer
  • Payments for diagnostic X-rays in hospital emergency departments
  • Financial status of hospitals in the New Orleans area


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