OIG will hunt for new E/M, incident-to errors and highly paid docs next year

Why This Topic Matters

It helps readers identify compliance and audit risk areas that may affect physician practices and Medicare billing processes. The article provides a high-level view of federal enforcement priorities without serving as a coding how-to guide.

Article Sections

1. Federal audits

   An overview of the Work Plan areas discussed in the article and the general audit themes tied to Medicare billing and payment review.

2. Incident-to billing

   Discussion of planned review activity involving services billed under incident-to arrangements and related oversight concerns.

3. E/M: Use of modifiers during the global period

   Coverage of planned review of evaluation and management services and modifier use during the global surgery period.

4. High Cumulative Part B Payments

   Summary of planned scrutiny involving unusually high cumulative Part B payments to physicians or suppliers.

5. Payments for the drug Herceptin

   Discussion of planned review of drug wastage-related payments and related oversight for a specific medication context.

6. Repeat targets

   A list of recurring Work Plan topics that continue to receive attention in Medicare audits and reviews.