OIG Releases 2012 Work Plan

Among the new areas of focus for the Office of Inspector General (the “OIG”) is increased scrutiny for incident-to services performed by non-physician practitioners.  Specifically, the OIG is planning on investigating whether the non-physician practitioners are qualified to be performing the incident-to services that are being billed by physicians.  This concern and others are highlighted in the recently published 2012 OIG Work Plan.  Your practice can use this Work Plan to help keep your compliance plan current.  Doing so allows your practice to be prepared for any audit or investigation by the OIG.

The Work Plan contains 349 new and continuing initiatives.  Others include:

  • Ensuring that physicians who have opted out of Medicare are no longer submitting claims;
  • Reviewing the qualifications to become a critical access hospital;
  • Investigating whether physician’s services were properly coded to the appropriate place of service (i.e. provided in a hospital vs. the physician’s office); and
  • Examining the safety and quality of care for patients having surgeries and procedures in ambulatory surgical centers.

The entire Work Plan can be read at: OIG 2012 Work Plan

© 2011 Parsonage Vandenack Williams LLC

For more information, contact info@pvwlaw.com

Same Day Surgery Restrictions Removed for Ambulatory Surgical Centers

A new rule allows ambulatory surgical centers to provide patient notifications on the day of the surgery, effectively eliminating the so-called prior-day notification requirement.  Prior to this rule, same day surgeries were only allowed in emergencies.  The final rule is expected to take effect on December 23, 2011.

The rule, provided by the Center for Medicare & Medicaid Services, can be viewed at: Final Rule

© 2011 Parsonage Vandenack Williams LLC

For more information, contact info@pvwlaw.com

Nebraska Will Wait to Implement Health Care Exchanges

Governor Heineman recently said Nebraska will wait to set up a health care exchange until the U.S. Supreme Court rules on whether the Patient Protection and Affordable Care Act (the “Act”) is constitutional.  The health care exchanges are intended to offer health insurance to those currently without coverage.  While Nebraska is planning a program in case the Act is ruled constitutional, Governor Heineman said it does not make sense to build a formal proposal until the Court has decided.  The Act requires states to have a health care exchange plan certified by January of 2013.

© 2011 Parsonage Vandenack Williams LLC

For more information, contact info@pvwlaw.com