tci Part B Insider - 2007 Issue 39

COMPLIANCE: Collecting From Both Part A and B Isn't Twice as Nice to the OIG

Even outpatient lab services are included in the DRGs for most inpatientsThe HHS Office of Inspector General (OIG) recently audited a carrier's Part B lab payments, and the results weren't pretty--the insurer paid more than $292,000 to labs that performed services for inpatients. The problem was that Part A had already included payment for those services in the hospital's DRG payment, meaning that the lab collected twice. The OIG reviewed payments by National Heritage Insurance Company (NHIC) for the technical component of lab services performed in 2005. In the audit report released last week, the OIG noted the...

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