COMPLIANCE: Watch Out--OIG Zeroes In On Incident-To Billing

Why This Topic Matters

OIG work plan items often signal areas of increased audit attention. Understanding the broad compliance themes helps organizations assess risk and prepare documentation and billing processes for review.

Article Sections

1. OIG 2007 Work Plan Overview

   Introduces the federal oversight focus for the coming year and frames the compliance topics included in the work plan.

2. Incident-to Billing

   Discusses the planned review of incident-to services, including supervision, medical necessity, documentation, and quality-of-care concerns.

3. Global Period Services

   Covers the agency’s interest in services reported during postoperative global periods and broader practice patterns.

4. Assignment Violations

   Summarizes concerns about Medicare assignment and patient billing practices, along with awareness of beneficiary rights.

5. Imaging Services

   Addresses the growth of advanced imaging utilization in physician offices and the OIG’s interest in billing oversight for these services.

6. Physical Therapy

   Describes the review of potential billing issues involving physical therapy services and coordination between Medicare payment parts.

7. Eye Surgery

   Notes planned scrutiny of cataract and laser vision procedures and the adequacy of carrier controls.

8. Place of Service

   Explores site-of-service concerns involving ambulatory surgery centers and hospital outpatient departments.

9. Inpatient Psychiatric Services

   Highlights the OIG’s interest in therapy setting and billing patterns within inpatient psychiatric care.

10. Polysomnography

    Summarizes the focus on sleep testing payment growth and related oversight questions.

11. Long-distance Claims

    Covers prior findings related to claims for patients living far from the service location and the expectation of face-to-face care.