decisionhealth Newsletters, Coder Pink Sheets - 2014 Issue 12 (December)
Watch for scrutiny of imaging, POS and electronic health records issues
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Article Overview
This article summarizes the Office of Inspector General’s 2015 Work Plan and highlights the Medicare compliance areas expected to receive closer review. It is relevant to providers, compliance staff, billing teams, and organizations that manage imaging, outpatient services, EHR participation, or contractor relationships. The article covers broad audit themes, including imaging-related payment scrutiny, place-of-service coding concerns, meaningful use incentive oversight, and review of federal contractors and program integrity activities.
Why This Topic Matters
The article helps readers identify areas that may face heightened audit attention and compliance review. Understanding these Work Plan priorities can help organizations assess internal processes and focus monitoring efforts where government scrutiny is expected.
Article Sections
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Compliance
Introduces the OIG Work Plan and describes its overall focus on payment and program integrity topics. It also notes the mix of new and recurring review areas.
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Part B specialties targeted
Summarizes the specialty and service areas identified for heightened Part B attention. The section addresses imaging, place-of-service issues, and outpatient therapy oversight at a broad level.
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EHR users under fire
Covers OIG attention to electronic health records and the Medicare and Medicaid meaningful use incentive programs. It also mentions related oversight of covered entities, business associates, and EHR vendors.
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OIG to scrutinize federal agencies, contractors
Describes planned review of CMS contractor performance and program integrity contractor activities. The discussion is centered on administrative and oversight-related responsibilities.
What You Will Learn
- What the OIG’s 2015 Work Plan emphasizes for Medicare compliance.
- Which broad categories of services and operations are expected to receive review.
- How EHR-related incentive programs and related privacy/security oversight fit into the Work Plan.
- Why contractor performance and administrative costs are part of the compliance landscape.
Who Should Read This
- Physicians
- Medical practice administrators
- Compliance officers
- Billing and coding staff
- Health information management professionals
- Healthcare contractors
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