Updates by Reed Smith on U.S. legislative & regulatory developments affecting the health care industry
This post was written by Nancy Sheliga.
On October 9, 2013, the OIG released a report focused on questionable Medicare billing for polysomnography services in 2011. Polysomnography is a type of sleep study that has seen increasing Medicare spending over the past few years and that the OIG notes has been identified as being…
In a report entitled “Questionable Billing for Medicare Independent Diagnostic Testing Facility Services,” the OIG discusses its examination of geographic patterns in Medicare independent diagnostic testing facility (IDTF) billing, in which it reviewed 2009 claims by Core Based Statistical Area (CBSA). According to the OIG, 20 high-utilization CBSAs with 2.2% of the total…
The OIG has created a “spotlight page” on its website to highlight its reports and findings involving the Medicaid drug rebate program. The page features comparisons of drug spending under Medicaid and Medicare Part D, manufacturer compliance with Average Manufacturer Price reporting requirements, manufacturer development of new versions of existing brand-name drugs to minimize rebate…
The OIG has created a “spotlight page” on its website that compiles information on previous OIG investigations involving independent diagnostic testing facilities (IDTFs) — Medicare providers that furnish diagnostic services independent from a physician’s office or hospital. According to the OIG, “IDTF services have historically been vulnerable to abuse,” and thus have been a topic…
The OIG has issued two new reports that reveal the plans of CMS to conduct more unannounced site visits of independent diagnostic testing facilities (IDTFs) nationally. The reports describe findings that in Miami and Los Angeles, IDTFs did not comply with Medicare standards requiring IDTFs to: (1) maintain a physical facility at the location on…
