Other Issuances: OIG posts audits of IRF transfers, oxaliplatin, and more
Medicare Weekly Update, July 13, 2010
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OIG reviews IRF transfer compliance
On June 29, the OIG issued a review of inpatient rehabilitation facilities’ (IRF) compliance with Medicare’s transfer regulation during fiscal years 2004 through 2007. The OIG determined that IRFs did not always code claims in compliance with Medicare’s transfer regulation. Medicare pays the full prospective payment to an IRF that discharges a beneficiary to home. In contrast, Medicare pays a lesser amount for a transfer case.
OIG audits oxaliplatin billing
On June 29, the OIG issued a report on oxaliplatin billing at Bayshore Medical Center. The OIG found that for calendar year 2005, Bayshore billed for at least 10 times the number of units of oxaliplatin than were actually administered and received overpayments totaling $276,000 for the nine outpatient claims reviewed.
OIG audits outpatient infusion therapy, lithotripsy, and blood administration services
On June 24, the OIG posted an audit report of outpatient infusion therapy, lithotripsy, and blood administration services provided at Providence Hospital in Washington, DC. The OIG determined that payments received by Providence Hospital from its Medicare contractor for 1,448 claims were not appropriate. Each of these claims had errors relating to outpatient infusion therapy, lithotripsy, or blood administration services. As a result, Providence Hospital received overpayments totaling $127,000 for 1,479 outpatient services.
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