decisionhealth Newsletters, Part B News - 2009 Issue 10 (October)
Imaging, e-prescribing, referrals top list of new OIG targets
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Article Overview
This article reviews major items in the HHS Office of Inspector General’s 2010 Work Plan that are relevant to physician practices and other Medicare providers. It covers the general scope of planned oversight involving e-prescribing, imaging, referrals, durable medical equipment, prescription drugs, contractor reviews, appeals, and other compliance-related topics. The piece is useful for compliance staff, billing managers, coders, and physicians who want to understand which service areas and administrative processes are drawing government attention.
Why This Topic Matters
The Work Plan signals where federal auditors may focus review activity, so practices can identify compliance areas that may warrant closer internal monitoring and training.
Article Sections
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Overview of the 2010 OIG Work Plan
Introduces the new Work Plan and the broad Medicare-related areas receiving oversight attention. It frames the article’s focus on physician practices and compliance review priorities.
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Targets affecting physician practices
Summarizes several physician-facing review areas discussed in the Work Plan, including enrollment, referrals, pain management, and claim data issues. The section also notes recurring topics carried forward from prior years.
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DME and prescription drug reviews
Covers oversight areas tied to durable medical equipment and selected Part B drug payment reviews. It highlights the general compliance themes the OIG plans to examine in these categories.
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Internal review of contractors and administrative processes
Describes planned reviews of Medicare contractors and their interactions with providers. The section addresses appeals, education efforts, and related oversight activity.
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Popular repeats on the OIG watch list
Notes additional recurring review topics that remain on the OIG radar. It provides a brief closing look at areas the agency plans to revisit.
What You Will Learn
- What the 2010 OIG Work Plan says about Medicare compliance priorities
- Which broad service categories are under review
- How the article frames physician practice areas of concern
- What types of contractor and administrative processes are included in oversight
- Which recurring themes continue to appear on the OIG watch list
Who Should Read This
- Physicians
- Medical practice managers
- Medical coders
- Billing staff
- Compliance officers
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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