In Audit
Apr 18th, 2018
Last June, U.S. Department of Health and Human Services (HHS) announced an ongoing effort to enhance transparency. One of its efforts has become updating the Office of Inspector General’s (OIG) Work Plan monthly, rather than annually. Another step HHS took to increase compliance transparency is by providing new tools and resources for the public to ...
In Audit
Jan 19th, 2017
In the 2017 Work Plan, the Office of Inspector General (OIG) is reviewing Medicare’s billing and reimbursement integrity for two diagnosis-related groups (DRGs): inpatient claims for kwashiorkor diagnosis and mechanical ventilation. Kwashiorkor is a severe protein malnutrition that usually “affects children living in tropical and subtropical parts of the world during periods of famine or ...
In Billing
Jun 5th, 2015
The Office of Inspector General (OIG) indicates in its mid-year update to the 2015 Work Plan that it will review Medicare outpatient payments for intensity-modulated radiation therapy (IMRT), beginning in 2016. Prior OIG reviews have identified hospitals that have incorrectly billed for IMRT services. How certain are you that claims payments your facility received were in accordance ...
Know where auditors are focusing and build a solid defense. By Elin Baklid-Kunz, MBA, CHC, CPC, CCS The Department of Health & Human Services has an agenda—to put measures in place that both increase quality of care and decrease government spending, due mainly to healthcare fraud and abuse. Not one of us is exempt from ...
In Audit
Oct 30th, 2013
If you want to get a jump start on your practice or hospital’s auditing and monitoring program as part of your compliance plan for 2014, you’ll have to wait. The U.S. Department of Health & Human Services (HHS) Office of Inspector General’s (OIG) 2014 Work Plan will not be released until January 2014. The OIG ...