decisionhealth Newsletters, Part B News - 2012 Issue 10 (October)
OIG targets NPP billing, incident-to and payments in 2013 Work Plan
Subscribe or sign in to view the full article.
Article Overview
This article reviews several 2013 Office of Inspector General Work Plan focus areas that affect non-physician practitioners, physician practices, and outpatient billing oversight. It discusses the general scope of review across billing, payment integrity, laboratory services, incident-to services, drug reimbursement, outpatient therapy, and chiropractic services. The piece is useful for compliance, auditing, and revenue cycle professionals who monitor Medicare and related payment risk.
Why This Topic Matters
It helps practices and billing teams understand where federal auditors planned to focus review activity in 2013, especially for services commonly billed by or involving non-physician practitioners. That makes it relevant for compliance review, audit readiness, and internal monitoring priorities.
Article Sections
-
Overview of OIG Work Plan targets for NPP services
Introduces the article’s focus on federal oversight priorities affecting non-physician practitioners and related billing activity. Summarizes the general scope of the 2013 Work Plan review items.
-
Past-due overpayments
Covers the Work Plan item related to unresolved overpayment debt and billing patterns that may be associated with continued Medicare payment risk. Discusses practice-level and individual-level compliance concerns at a high level.
-
Bad billing practices for Part B clinical lab services in 2010
Addresses the planned review of clinical laboratory billing patterns and utilization trends under Medicare Part B. Focuses on the audit subject area rather than any individual billing determination.
-
Incident-to billing
Summarizes the OIG’s continued interest in incident-to claims and CMS monitoring of those services. Notes that this remains an audit area for payment integrity review.
-
CMS payments for provider-administered drugs and biologicals
Covers the planned evaluation of reimbursement policy for provider-administered drugs and biologicals, including related Medicare and Medicaid payment oversight topics.
-
Outpatient physical therapy services
Discusses the planned audit of outpatient physical therapy services provided by independent therapists and utilization patterns. Frames the topic as a compliance and documentation review area.
-
Chiropractic services
Reviews the repeated Work Plan focus on chiropractic services and Medicare payment oversight. Covers the general audit concern involving maintenance or ongoing services.
What You Will Learn
- Which non-physician practitioner billing areas were included in the OIG’s 2013 Work Plan
- What types of Medicare payment oversight topics were highlighted for audit review
- Which general service categories were singled out for compliance scrutiny
- How the article frames incident-to billing, laboratory services, drug reimbursement, therapy, and chiropractic oversight
Who Should Read This
- Medical coders
- Billing specialists
- Compliance officers
- Revenue cycle managers
- Practice administrators
- Auditors
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com