decisionhealth Newsletters, Part B News - 2012 Issue 10 (October)
OIG releases 2013 Work Plan, expands targets on Part B and drug payments
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Article Overview
This article reviews new and continuing Office of Inspector General (OIG) audit and compliance priorities for 2013. It focuses on Medicare Part B oversight, ophthalmology services, electrodiagnostic testing, drug reimbursement issues, liability-related claim modifiers, and a new investigation into drug shortages. It is most relevant for providers, coders, billing staff, and compliance teams tracking federal audit risk and documentation expectations.
Why This Topic Matters
The article helps readers understand where OIG is increasing scrutiny so they can assess compliance exposure and prepare for audits related to Part B services, ophthalmology, electrodiagnostic testing, and drug claims.
Article Sections
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Compliance
Introduces the article’s compliance focus and frames the OIG work plan changes affecting Medicare-related billing and oversight.
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New target areas in the 2013 Work Plan
Summarizes several audit priorities involving electrodiagnostic services, ophthalmology, liability-related claim handling, and immunosuppressive drug billing.
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New OIG drug shortages investigation
Describes the OIG’s new focus on how drug shortages affect providers, reporting practices, and broader care and market impacts.
What You Will Learn
- What categories of Medicare Part B services are under increased OIG scrutiny
- Which general billing and compliance areas are highlighted in the 2013 Work Plan
- How the article frames audit attention related to drug reimbursement and shortages
- What kinds of provider and billing issues the OIG says it will examine
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Physician practices
- Medicare providers
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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