Review ambulance medical necessity before the OIG audits your facility
Health Care Auditing Strategies, May 1, 2006
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The OIG is watching this difficult compliance area
If you work for a hospital, ambulance transports may not seem like an area that you need to audit. However, that's no longer the case.
In an audit report released in January, the OIG recommended that ambulance contractors educate third-party healthcare providers who initiate ambulance transports about complying with Medicare regulations. Thereafter, the OIG said CMS "may want to determine if it can take administrative action and refer any potentially fraudulent or abusive providers to the OIG."
If ambulance providers succumb to OIG pressure to stop providing medically unnecessary ambulance services, physicians may be tempted to alter medical charts to ensure that patients who are not as sick still qualify for ambulance transportation.
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