tci Medicare Compliance & Reimbursement - 2016 Issue 9

Compliance: OIG Takes Aim at Outpatient Payments

Plus: EHR efforts fall short. The HHS Office of the Inspector-General’s (OIG) latest Compendium of Unimplemented Recommendations, released on April 12, is a laundry list of missed opportunities for the U.S. Department of Human and Health Services (HHS). Case in point: During a previous review, OIG found that Medicare could save $15 billion between 2012 and 2017 by reducing outpatient department payment rates for ASC-approved procedures to the same levels that ASCs collect for these services, in cases when patients have low-risk and no-risk clinical needs. That’s because the ASC payment rates are lower than hospital...

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