OIG work plan: MRI use, reassignment targeted for 2008; Reassignment, MRI use among new OIG targets in 2008

Why This Topic Matters

The OIG Work Plan often signals where audits and enforcement activity may increase. Knowing the broad subject areas helps providers and billing teams review compliance risks, documentation practices, and payment integrity concerns before claims are examined.

Article Sections

1. Overview of the 2008 OIG Work Plan

   Introduces the Work Plan as advance notice of topics likely to receive audit scrutiny. Frames the article’s focus on Medicare billing and compliance review areas.

2. Selected physician services

   Discusses the OIG’s planned review of certain physician services billed to Medicare. Emphasizes the broad compliance implications for physician billing practices.

3. Imaging, utilization, and provider relationships

   Covers MRI-related business relationships, ultrasound utilization patterns, and geographic concentration of services. Focuses on how these areas are being examined from a Medicare oversight perspective.

4. Reassignment, assignment, and balance billing

   Addresses reassignment arrangements and the separate issue of accepting assignment. Describes these as audit focus areas tied to billing relationships and patient billing concerns.

5. Non-physician practitioner and related service reviews

   Summarizes OIG review areas involving chiropractic services, clinical social workers, incident-to services, and physician distance from certain care settings. Highlights the role of Medicare payment rules and service oversight.

6. Drug payment and high-cost billing reviews

   Covers OIG scrutiny of average sales price-based reimbursement, excessive dosages, and chemotherapy administration claims. These topics are presented as part of broader Medicare payment integrity review efforts.

7. ASC payment methodology

   Notes the planned review of ambulatory surgery center payment methodology. Focuses on how CMS established the payment framework under the updated approach.