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ASCs in the news: Something old, something new for ASCs in the OIG 2009 work plan

Ambulatory Surgery Reimbursement Update, October 14, 2008

The Department of Health and Human Services Office of Inspector General (OIG), released its work plan for fiscal year (FY) 2009 on October 1, and a number of the review topics affect ASCs directly or indirectly. OIG plans to continue analyzing a number of the same areas that it did in 2008. In addition, reviews will probe new areas, consistent with federal concerns throughout the industry.

Look for reviews to continue in these areas:

• ASC payment rates and rate-setting methods

• Services and billing patterns in geographic areas with high numbers of independent diagnostic testing facilities and ultrasound services

• Reassignment of benefits by Medicare physicians to other entities, including ASCs

Additional OIG work plan priorities for 2009 include review of:

• Physician coding of place of service on Part B claims for services performed in ASCs

• Appropriateness of payments for colonoscopy services

• Controls for ensuring accuracy of quality of care data

• Incidence of never events

To read the complete OIG work plan for FY 2009, click here.

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