The 2014 OIG Work Plan includes the following: Billing and Payments. We will identify questionable billing patterns associated with nursing homes and Medicare providers for Part B services provided to nursing home residents during stays not paid under Part A (for example, stays during which benefits are exhausted or the 3-day prior-inpatient-stay requirement is not … Continue Reading
The 2014 OIG Work Plan includes the following: Policies and Practices. We will determine the impact of subordinate facilities in hospitals billing Medicare as being hospital based (provider based) and the extent to which such facilities meet CMS’s criteria. Context—Provider-based status allows a subordinate facility to bill as part of the main provider. Provider-based status … Continue Reading
The 2014 OIG Work Plan includes the following: Quality of Care and Safety. We will determine how hospitals assess medical staff candidates prior to granting initial privileges, including verification of credentials and review of the National Practitioner Databank. Context—Hospitals that participate in Medicare must have an organized medical staff that periodically appraises its members (42 … Continue Reading
The following is the Med Law Blog’s Top 10 List for Areas of Interest in the OIG 2010 Work Plan for physicians and providers, which will draw particular scrutiny next year: 1. Medicare Incentive Payment for E-Prescribing 2. Practice Expense Components of Diagnostic Imaging 3. Outpatient Physical Therapy Services by Independent Therapists 4. Place of … Continue Reading
