Health Information Management

News: OIG Work Plan targets inpatient, outpatient mix for 2012

CDI Strategies, November 10, 2011

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The auditing arm of the Department of Health and Human Services (HHS) plans to crack down on hospital performance in the areas of reporting of adverse events and quality measure data, present on admission coding, inpatient outlier payments, and same-day readmissions.

Those are some of the highlights of the Office of Inspector General’s (OIG) Fiscal Year 2012Work Plan, which outlines the OIG’s target areas, released October 5.
One new investigation will review Medicare inpatient and outpatient payments to acute care hospitals to “determine compliance with selected billing requirements,” and use the results of those reviews “to recommend recovery of overpayments and identify providers that routinely submit improper claims,” the Work Plan states.
The annual Work Plan release provides CDI professionals another glimpse into areas CMS deems targets for risk and/or abuse, providing a potential focus for documentation improvement efforts.

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