GOV’T AUDIT INSIDER: Washington state should revise per diem rates, says OIG
Healthcare Auditing Weekly, April 12, 2005
Washington state should revise per diem rates, says OIG
From January 2003 through June 2004, United Healthcare of Ohio received Medicare overpayments of $13,128 for 20 beneficiaries that United incorrectly reported as institutionalized, according to an OIG audit report. United officials stated the incorrect claims were due to administrative and clerical errors and because institutions did not always provide correct information to verify the institutionalized status of the beneficiaries. The OIG recommends that United refund $13,128 to the federal government and ensure that capitation payments for beneficiaries reported as institutionalized are claimed in accordance with federal laws and regulations.
During the audit, the OIG did the following:
Click here to read the audit report, "Review of Medicare Payments for Beneficiaries With Institutional Status at United Healthcare of Ohio," (A-07-04-01011) issued March 18.
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- Cohesive History and Physical Requirements
- Searched