• E-mail
• Print
• RSS

OIG sets its sights on familiar targets in 2006 Work Plan

Executive Briefings Digest, February 21, 2006

Want to receive articles like this one in your inbox? Subscribe to Executive Briefings Digest!

Below are three of the major outpatient procedures/services highlighted by the Office of Inspector General (OIG) in its recently released 2006 Work Plan:

1. Medicare Part B payments for radiology services. The OIG will examine claims to make sure that hospitals aren't receiving Part B (outpatient) payment for inpatients. The OIG cites a 2001 survey indicating that hospitals were improperly paid a "significant amount" for radiology services when the beneficiary was an inpatient.
2. Coronary artery stents. The OIG will examine both inpatient and outpatient claims involving arterial stent implantation for medical necessity that is supported by adequate documentation. It also wants to know whether beneficiaries who had stent implantations during multiple surgical procedures should have had the implantations done simultaneously.
3. Payments for observation services versus inpatient admissions for dialysis services. The OIG will audit to determine whether payments were made for inpatient admissions for dialysis services when the physician's orders stated that the level of care warranted less expensive observation status instead. The OIG says that during a recent audit, hospitals admitted patients for dialysis treatment lasting 24-48 hours, although a review of the documentation indicated that the stays were for the purpose of observation rather than treatment.

Source: Briefings on APCs

Want to receive articles like this one in your inbox? Subscribe to Executive Briefings Digest!

• E-mail to a Colleague
• Print
• RSS
• Archive