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Industry News: OIG

OIG Reports More Than $3 Billion in Expected Recoveries from Fighting Fraud, Waste, and Abuse for the First Half of FY 2010

Friday, June 25, 2010

In its "Semiannual Report to Congress," the Office of Inspector General (OIG), Department of Health & Human Services (HHS), announced expected recoveries of more than $3 billion for the first half of fiscal year (FY) 2010.

New OIG Hotline Site
Thursday, May 27, 2010
The Office of Inspector General (OIG) recognizes the importance of public vigilance in combating fraud, waste, and abuse. The OIG Hotline provides an outlet for the general public to report allegations of wrongdoing in Department programs. To facilitate the reporting process, OIG has updated the Hotline page on its website. In addition to providing some general guidance on the types of complaints most commonly received, the new page includes an online complaint form that prompts users to provide relevant and complete information.

OIG Workplan 2009
Wednesday, January 27, 2010

These are some of the focus areas in the 2009 OIG Work plan that laboratories should be aware of:

Medicare Payments for Unlisted Procedure Codes
OIG will review the accuracy of Medicare payments for services billed using unlisted procedure codes. Unlisted procedure codes are not paid under the fee schedule. The Medicare contractors that process such claims suspend them for individual review and manual pricing.

OIG Work Plan 2010

Tuesday, November 24, 2009

Medicare Secondary Payer

  • Assess the effectiveness of preventing inappropriate Medicare payments for beneficiaries with other insurance coverage and identify credit balance situations, which occur when payments from Medicare and other insurers exceed the providers charges or the allowed amounts.

Hospital Readmission

  • Based on prior OIG work, CMS implemented an edit in 2004 to reject subsequent claims on behalf of beneficiaries who were readmitted to the same hospital on the same day.

Payments for