tci Medicare Compliance & Reimbursement - 2015 Issue 7

Compliance: EHR Fraud Vulnerabilities On OIG Hit List

Watch out: Payment threshold for manual review in the works. The HHS Office of the Inspector General (OIG) has noted in a new report that though it makes hundreds of recommendations each year, these are usually disregarded.  On March 16, the OIG released its Compendium of Unimplemented Recommendations, which revealed that Part B contractors, medical practices and facilities have overlooked many OIG suggestions advising practices and carriers to tighten up documentation, correct their modifier use, and implement other programs. Case in point: In 2013, the OIG found that about 2 percent of clinicians were responsible for collecting almost...

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