星空入口

NEWS YOU CAN USE: Dana Corrigan Appointed Interim Head of OIG

 
 As OIG chief Janet Rehnquist steps down, HHS Secretary Tommy Thompson announced May 30 that Dana Corrigan will act as the interim OIG head until a new Inspector General is appointed. Corrigan's experience as director of program integrity for CMS where she was responsible for Medicare enforcement and integrity makes her no stranger to healthcare fraud and abuse investigations.
 

 A recent release from the HHS Office of the Inspector General (OIG) reports saving taxpayers more than $12 billion this year, a fat chunk of which they scored in a fraud settlement with a New Mexico hospital. After getting busted for submitting 10 years of shady Medicare cost reports and reopening requests, the facility agreed to pay $24.5 million to the feds the heftiest settlement of its kind to date.
 

 Heads up, hospitals: In a news brief released June 3, the OIG also announced it could slice Medicare payments by more than $1 billion each year. The catch: To do it, they need to set up uniform reimbursements for outpatient services furnished in hospital outpatient departments and ambulatory surgical centers.
 

 Good news for providers furnishing outpatient diabetes self-management training (DSMT): The "incident-to" requirement no longer applies for these services, so go ahead and bill using these codes, as long as a qualified person provides the care:

G0108 Diabetes outpatient self-management training services, individual, per 30 minutes

G0109 Diabetes self-management training services, group session (2 or more), per 30 minutes.
 

 Make sure your recordkeeping is on the right page, or there could be federal trouble: Recent OIG investigation of a Pennsylvania hospital network yielded accusations of upcoding and unsupported claims due to lack of proper documentation. Albert Einstein Healthcare Network underwent a government audit, and while not confessing misconduct, they agreed to pay almost $2 million to settle the case.


 According to CMS Program Memorandum A-03-048, released June 6, NCCI edits for computer-aided detection devices are out of the Outpatient Code Editor, but will sneak back into action in a later release.  
 



- Published on 2003-06-01