Jun 11th, 2015
by John Verhovshek, MA, CPC The first step to achieving healthcare compliance is: Have a plan. Policies, standards, and procedures prevent ambiguity and indecision, and demonstrate a good faith effort to achieve compliance. When robustly communicated and observed, standards and procedures establish tighter internal controls to counter potential risks. Even absent the formality of specific ...
Feb 17th, 2015
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently posted a seven minute video to its video newsroom website to provide additional details about how it decides upon Work Plan targets, “best practices” to assure compliance, Medicaid expansion, and more. On the same web page, you will also find brief ...
In Audit
Feb 4th, 2015
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) oversight and investigations efforts are expected to recover a record-breaking $4.9 billion to the government for fiscal year (FY) 2014. Each recent year has established a new record, with $4.3 billion recovered in 2013 and $4.2 billion recovered in 2012. Total Federal ...
In Audit
Aug 21st, 2014
Once again, the OIG has included place of service (POS) errors as a focus of its annual Work Plan: We will review physicians’ coding on Medicare Part B claims for services performed in ambulatory surgical centers and hospital outpatient departments to determine whether they properly coded the places of service. Context—Prior OIG reviews determined that ...
Jan 29th, 2013
Many offices use place of service (POS) code 11 Office incorrectly for minor surgeries at an ambulatory surgical center (ASC) or in the outpatient department of a hospital. You should apply POS 11 only for those services provided in the physician office. The Office of the Inspector General (OIG) reviewed a sample of outpatient surgery ...