Eli's Rehab Report

Published on Sat Jan 27, 2007 PDF

The HHS Office of Inspector General recently released its 2008 Work Plan, and rehab services are clearly on the radar.

Same old story: As usual, the OIG will be targeting issues such as medical necessity and appropriateness of payments. The following are specific settings the agency noted as review targets:

• CORFs. The OIG promised to look at comprehensive outpatient rehabilitation facilities' PT, OT and SLP claims. These plans are products of prior reviews the OIG conducted in outpatient rehab facilities and nursing homes that revealed questionable billing practices.

• HHAs: The OIG plans to audit Part B therapy claims for home health and did not mention auditing therapy claims on PPS episodes. But that doesn't mean you should relax. The feds will still have their eye on home health therapy under PPS (see the home health article in Physical Medicine & Rehab Coding Alert Vol. 8, No. 12).

• SNFs: The OIG will also have its eye on Part B services provided in nursing homes. That could include rehab services.

• Medicaid payments: Finally, the OIG plans to review the appropriateness of PT and OT claims paid by state Medicaid programs.

Note: For the full Work Plan, visit http://oig.hhs.gov/publications/docs/workplan/2008/Work_Plan_FY_2008.pdf.