HC Compliance Essentials

DME: OIG Finds 60% Of Wheelchair Claims Don’t Meet Medicare Requirements

Industry points finger at confusing, overly complex documentation rules. You may think the seat can’t get any hotter for durable medical equipment suppliers, but the HHS Office of Inspector General just turned the heat up another notch. Three out of…

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OIG Report Cites Care-Plan Related Problems for Nursing Home Hospice Patients

One key strategy can protect your facility’s survey record. If a recent OIG report about hospice nursing home patients isn’t on your facility’s radar screen, your staff may be missing an important risk management opportunity. OIG Memorandum Report, “

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Compliance Tip: High Hospital Physician Salaries Can Trigger Anti-Kickback Concerns

Find out what could put you in jeopardy. If you think hospital physician compensation that exceeds fair market value can only trigger Stark concerns, beware. What is true: The anti-kickback law has a safe harbor for employment relationships that doesn’t…

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OIG 2010 Work Plan: Physicians’ Imaging Services

OIG sides with Physician Fee Schedule on the controversial imaging reimbursement question. In the OIG’s 2010 Work Plan, concern over payments for imaging services shows up several times, and physician practices should prepare for increased scrutiny payments…

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How One Hospital’s Physician Gifts Ran Afoul of Stark

One lesson learned: A central tracking system can flag multiple gifts. Your hospital can learn a lot from the mistakes of others, especially when it comes to the slippery Stark rules. On June 26, 2009, the…

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Audit Alert: Ambulance Services for Part A SNF Residents

Many ambulance services for Part A SNF residents are being billed to Medicare twice — once to Part A under Consolidated Billing and once to Part B. And that mistake could have caused $12.7 million in improper payments in 2006, says…

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OIG Takes Aim at Physician POS Coding Errors

Physician coders, billers & compliance officers: If you feel like place of service errors are insignificant, you should know that the OIG feels otherwise. You may be aware of the fact that your physician earns higher reimbursement when he performs a service in his office…

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Look for RACs to Target Ultrasound Claims

Plus: The OIG identifies 20 counties it classifies as “high use” for ultrasounds. The OIG is watching ultrasound claims – and it doesn’t like what it sees. An OIG audit of ultrasound services billed in 2007 found that nearly one…

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