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
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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
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The OIG has issued a Special Fraud Alert, dated March 26, 2013, describing specific attributes and practices of Physician Owned Distributorships (PODs) believed to produce substantial fraud and abuse risk and pose dangers to patient safety.
PODs are physician owned entities that derive revenue from selling or arranging for the sale of implantable medical…
The Office of Inspector General of the Department of Health and Human Services has just released a report examining problems with incident to billing by physicians, and seeking restrictions on the use of that billing arrangement. The report, titled "Prevalence and Qualifications of Non-Physicians Who Performed Medicare Physician Services" was posed by the OIG on…
The Office of Inspector General of the Department of Health and Human Services has issued Advisory Opinion No. 09-05, which states that the OIG will not impose sanctions regarding a proposed on call arrangement in which the hospital will compensate physicians for providing on call coverage for patients presenting to the hospital or emergency department. The…
