Corporate Compliance

Other Issuances: CMS updates lab NCD manual, OIG issues adverse events case study, and more

Medicare Insider, December 30, 2008

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CMS updates NCD manual for clinical diagnostic laboratory services

CMS has released its January 2009 update to the NCD manual for clinical diagnostic laboratory services.

View the NCD manual.

OIG issues reports comparing average sales prices (ASP) to average manufacturer prices (AMP) for prescription drugs

The OIG released two reports comparing ASPs to AMPs for drugs reimbursed under Medicare Part B’s ASP-based methodology.

View the report on ASP vs. AMP for 2007.

View the report on ASP vs. AMP for first quarter, 2008.

OIG issues reports on high-dollar payments for inpatient and outpatient services processed by First Coast Service Options, Inc., for the period January 1, 2004 through December 31, 2005

The OIG released two reports on high-dollar payments for inpatient services and outpatient services processed by First Coast, a Medicare fiscal intermediary, for the period January 1, 2004 through December 31, 2005.

View the OIG report on inpatient high-dollar claims processed by First Coast.

View the OIG report on outpatient high-dollar claims processed by First Coast.

Frequently asked question

On December 22, CMS updated a frequently asked question regarding recent changes to the definitions of new and established patients under the OPPS.

How is the new or established patient classification determined under the Outpatient Prospective Payment System (OPPS)? For example, is a clinic patient considered new or established if he was treated in an off-site clinic of the hospital or the hospital’s emergency department within the past 3 years? (View answer.)

OIG issues adverse events case study

On December 19, the OIG issued a case study on the incidence of adverse events among Medicare beneficiaries in two select counties.

View the OIG report.



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