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OIG releases 2007 Work Plan

Ambulatory Surgery Reimbursement Update, October 3, 2006

The Deficit Reduction Act of 2005 (DRA) is a prominent theme of the 2007 Office of Inspector General (OIG) Work Plan, with investigators planning to review state false claims acts and several DRA-related programs.

The OIG released its Work Plan earlier than usual this year, on September 25. It lays out the OIG's plans for investigations into Medicare and Medicaid spending over the upcoming year.

Next year's Work Plan also introduces several new hospital-related investigations targeted at common billing schemes. Many of these topics have been on the government's radar for years, but this year's Work Plan indicates the OIG will renew its focus on the following areas:

• Upcoding of diagnosis related group (DRG) payments. The OIG plans to "analyze inpatient hospital claims to identify providers who exhibit high or unusual patterns for selected DRGs."
• Unbundling of hospital outpatient services.
• "Inpatient-only" services performed in the outpatient setting.

To read the OIG's Work Plan, click here.

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