OIG unveils 2009 Work Plan

Why This Topic Matters

The Work Plan signals where Medicare oversight may intensify, helping practices anticipate audit attention and review internal billing processes at a high level.

Article Sections

1. Work Plan overview

   Introduces the HHS Office of Inspector General’s annual planning document and its role in reviewing physician billing and Medicare-related activities.

2. Payments on GY modifier

   Discusses a compliance-focused review area involving claims submitted with a specific Medicare modifier and the general concern behind that review.

3. Payments on unlisted procedures

   Covers the planned review of claims involving unlisted services and broader questions about carrier pricing and payment patterns.

4. Place of service (POS) errors

   Addresses review of place of service reporting across settings such as offices, ambulatory surgical centers, and hospital outpatient departments.

5. Medicare payments for colonoscopy services

   Notes a Work Plan item tied to colonoscopy-related billing and associated ancillary services.

6. Ultrasound

   Summarizes planned scrutiny of utilization patterns for ultrasound services in selected geographic areas.

7. Outpatient physical therapy

   Describes ongoing review of outpatient physical therapy billing patterns and compliance with Medicare payment requirements.