decisionhealth Newsletters, Part B News - 2014 Issue 11 (November)
OIG Work Plan: Watch for specialty, electronic health record issues
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Article Overview
This article covers selected items from the Office of Inspector General’s 2015 Work Plan and highlights the compliance areas most likely to receive audit attention. It is aimed at coding, compliance, and revenue cycle professionals who monitor federal oversight trends, especially in Medicare and Medicaid, EHR incentive payments, and specialty-specific Part B review topics.
Why This Topic Matters
The Work Plan signals where federal auditors are likely to focus next, helping providers and billing teams identify compliance risks and prioritize internal review efforts.
Article Sections
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Compliance
Overview of the Work Plan’s scope and its role in signaling federal oversight priorities. The section frames the article’s focus on payment integrity and audit targets.
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EHR users under fire
Discussion of electronic health record-related review areas, including incentive payment oversight and protection of electronic health information by certain vendors and entities.
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Part B specialties targeted
Summary of specialty-specific Part B areas identified for increased attention, including professional services, diagnostic testing, imaging-related payments, and selected outpatient care settings.
What You Will Learn
- How the OIG Work Plan is used to identify audit priorities
- Which broad compliance areas received attention in the 2015 Work Plan
- What kinds of EHR-related oversight issues were highlighted
- Which specialty and Part B topic areas were singled out for review
Who Should Read This
- Medical coders
- Compliance officers
- Revenue cycle managers
- Billing staff
- Healthcare administrators
- Auditors
Codes Discussed
Modifiers Discussed
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