News & Press: Advocacy

The OIG Issues a Work Plan for 2012

Friday, February 03, 2012  
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The Office of Inspector General (OIG) has issued the Work Plan for 2012, outlining the priorities for the upcoming year. The full Work Plan can be reviewed by clicking here. Some areas of interest, listed under the physician section include:

  • E/M blling - Review of coding trends, outliers, billing during global periods and inappropriate or inadequate documentation.
  • Place of Service - The payment provided to physicians for practice expenses is higher when services are provided in an office setting - therefore reporting of an inappropriate place of service might result in overpayment.
  • Safety and Quality of Surgery and Procedures performed in Ambulatory Surgery Centers - As the number of procedures performed in the ASCs is increasing the OIG will be looking at the quality of care in those settings.
  • "Incident-to" Services - Review physician billing for "incident-to" services to determine whether payment for such services had a higher error rate than that for non-incident-to services, and whether services are performed by unqualified nonphysicians - which may lead to overutilization and expose Medicare beneficiaries to care that does not meet professional standards of quality.

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