OIG to scrutinize ABNs, private contracting and podiatry services in 2000

Why This Topic Matters

The article highlights areas that Medicare auditors planned to examine more closely, which can affect compliance risk, documentation practices, and billing scrutiny across several specialties and service types.

Article Sections

1. Private contracting and advance beneficiary notices

   Summarizes the work plan focus on beneficiary-physician arrangements and Medicare notice practices. It describes why these topics were under review and the general compliance concerns involved.

2. Podiatry services

   Describes planned review of podiatry billing and service patterns. It notes the broader concern about error rates and coverage review.

3. Prescription drug pricing and related Medicare drug issues

   Covers OIG interest in drug pricing benchmarks, outpatient rebate possibilities, and atypical allowances for certain drugs. The section addresses Medicare reimbursement oversight for pharmaceuticals.

4. Hyperbaric oxygen therapy and home health monitoring

   Summarizes planned scrutiny of therapy utilization and physician oversight in home health settings. It focuses on Medicare service review and utilization patterns.

5. Resurfaced work plan items

   Lists several oversight topics carried forward from prior work plans. These items relate to billing systems, reassignment, teaching hospital claims, and imaging services.

6. Automated Billing Encoding Systems

   Addresses whether billing software and related processes contribute to Medicare billing errors. It also notes review of different billing workflows.

7. Reassignment

   Covers review of billing number reassignment practices and associated vulnerabilities. The focus is on Medicare billing administration.

8. Physicians at Teaching Hospitals (PATH)

   Discusses planned compliance review in teaching hospital settings. The section concerns whether claims align with the level of service provided.

9. Myocardial Perfusion Imaging

   Summarizes planned review of the appropriateness and utilization of a cardiac imaging service. The emphasis is on billing growth and medical review.