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OIG releases 2007 Work Plan

Physician Practice Advisor, October 4, 2006

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

The Work Plan covers the spectrum of healthcare, from medical necessity and coding issues to Medicaid drug reimbursement and care provided in nursing homes. Here is a run-down of physician-specific projects slated for this year:

  • Violations of assignment rules by Medicare providers-The OIG will evaluate the extent to which providers bill for beneficiaries in excess of amounts allowed by Medicare requirements.
  • Medicare reimbursement for polysomnography-The OIG will determine the factors contributing to a nearly 175% increase in Medicare reimbursements for polysomnography (i.e., a test used in the study of sleep).
  • "Long-distance" physician claims associated with home health and skilled nursing facility services-The OIG will review services that would normally require face-to-face examination for beneficiaries who live a significant distance from the physician's office.

Click here to read the OIG Work Plan.