Category Archives: OIG

Medicare Overpayments for Part B Claims with G Modifiers

Posted on May 7, 2013 by clbaer

Office of Inspector General (OIG) announced they recently finished a study on all Part B claims billed with G modifiers that the providers expect to be denied as either not “reasonable and necessary” (GA and GZ modifiers) or because they … Continue reading →

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OIG Outlook 2013 Video Program Now Available

Posted on October 25, 2012 by dzetter

The OIG has a new delivery vehicle to communicate its mission and endeavors.  The 2013 Work Plan was published this month and the OIG is wasting no time or effort in getting the word out.

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Office of Inspector General (OIG) 2013 Work Plan

Posted on October 11, 2012 by clbaer

Office of Inspector General released their 2013 OIG Work Plan last week. Some of the areas being targeted that are worth mentioning are as follows:

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RAC Audits are Coming to Physician Practices!

Posted on September 20, 2012 by dzetter

CMS communicated to the AMA on Wednesday, September 12, 2012, that it has approved the Medicare Region C Recovery Auditor(RAC) Connolly to begin conducting audits of coding for E&M services in physician offices, specifically CPT code 99215.  

Posted in CMS, Coding, Documentation, E/M, Medicare, Miscellaneous, OIG, Practice Management, Regulatory | Tagged , , , , , | Leave a comment

High Level E/M Codes are Coming Under Increased Scrutiny by the OIG

Posted on May 31, 2012 by dzetter

The May 8, 2012, Office of Inspector General’s report, Coding Trends of Medicare Evaluation and Management Services, says payments for E/M services increased 5% more than the rate of increase for all Part B payments from 2001 to 2010 (48% … Continue reading →

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Compliance Culture and Officer Should be Protected

Posted on March 9, 2012 by dzetter

There are new tools being provided by the Health and Human Services Office of Inspector General on compliance.  The office has been posting educational resources to its Compliance 101 Web page.  Some of the educational materials recently posted included A … Continue reading →

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Another Argument for Getting the Signatures Right

Posted on February 22, 2012 by dzetter

Reprinted from DecisionHealth Daily. An OIG report on claim payment denials shows a big, fat opportunity to reduce your own. OIG’s report on the “pilot prject to obtain missing documentation identified in the Fiscal Year 2010 CERT program” is mainly meant to … Continue reading →

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OIG Makes Available Federal Anti-kickback Statute Video and Podcast

Posted on December 12, 2011 by dzetter

The Anti-kickback Statute prohibits individuals or entities from knowingly and willfully offering, paying, soliciting, or receiving anything of value to induce or reward the referral of Federal health care program business. This audio and video podcast highlights what the statute … Continue reading →

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OIG Posts 2012 Work Plan

Posted on October 5, 2011 by dzetter

The Office of Inspector General’s ( OlG ) Work Plan sets forth various projects to be addressed during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and Office of Counsel to … Continue reading →

Posted in Healthcare, Medicare, OIG, Uncategorized | 1 Comment