Gov't audit insider 1/6/04: End stage renal disease providers come under the OIG's scrutiny.
Healthcare Auditing Weekly, January 6, 2004
The Office of Inspector General's (OIG) objective for this audit was to determine the extent of Medicare overpayments made to independent End Stage Renal Disease (ESRD) providers resulting from AdminaStar Federal's reimbursement of supplies used to administer separately billable injectable drugs.
The OIG performed the following steps:
1. Developed a universe of potential overpayments attributable to the error in AdminaStar's claim processing system.
2. To confirm the existence of overpayments in the created universe, the OIG randomly selected a sample of 100 lines of service and obtained the claim submitted by the provider.
3. Applying Medicare reimbursement regulations, the OIG manually recalculated the claim reimbursement for each of the sample line items.
4. The OIG confirmed that its previous calculated differences in the universe of 6,756 lines of service agreed with all manual recalculations.
Click here to read the audit report "End State Renal Disease Pricing Errors at Independent Facilities - AdminaStar Federal, Inc., Indianapolis, Indiana."
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