Corporate Compliance

Other issuances: OIG issues reviews of Medicare appeals at the Administrative Law Judge level in 2010 and payments to skilled nursing facilities in 2009

Medicare Insider, November 20, 2012

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OIG issues review of Medicare appeals at the Administrative Law Judge level

On November 15, the OIG issued a review of ALJ appeals decided in fiscal year 2010 which found that when CMS participated in appeals, ALJ decisions were less likely to be favorable to appellants. In addition, the OIG raised concerns about the acceptance of new evidence and the organization of case files.

View the OIG report.
 
OIG issues review of payments to skilled nursing facilities in 2009

On November 13, the OIG issued a review of payments made to skilled nursing facilities in 2009, which found that SNFs billed one-quarter of all claims in error that year, resulting in $1.5 billion in inappropriate Medicare payments.

View the OIG report.



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