Corporate Compliance

Other Issuances: RACs begin medical necessity reviews, OIG reviews separately billed outpatient infusion therapy services

Medicare Insider, August 17, 2010

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RAC posts medical necessity issues for review

On August 13, CGI Federal, the Region B RAC, posted the first issues for medical necessity review.

View CGI’s updated list of audit issues.

OIG audits outpatient infusion therapy services at Princeton Community Hospital

On July 28, the OIG issued a report on payments received by Princeton Community Hospital from its Medicare contractor for outpatient infusion therapy services. The OIG found that 762 of these claims were not appropriate because they were for outpatient infusion therapy services provided as part of a surgical procedure and therefore were not separately payable by Medicare. As a result, Princeton Community Hospital received overpayments totaling $106,000 for 1,387 outpatient services.

View the OIG report.



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