tci Outpatient Facility Coding Alert - 2016 Issue 8

Reader Question: OIG to Analyze Salaries within Hospital Cost Reports

Question: We have heard that the OIG work plan has listed outpatient reimbursement to be subjected to OIG scrutiny. What are the probable areas that we need to prepare ourselves in? Maine Subscriber Answer:The OIG work plan 2016, mid-year update does make mention of outpatient payments. Here is a precise list of areas to watch for: 1. Outpatient Outlier Payments for Short-Stay Claims: The OIG will target excessive outpatient patient outlier payments resulting from hospital outpatient services providing access to care in higher numbers. OIG plans to examine any unnecessarily inflated charges by the hospital that are not cost-based...

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