October 2003

Noncompliance may mean no Medicare reimbursements

Healthcare providers who don’t take compliance programs seriously may face being excluded from Medicare and Medicaid.

In its work plan for fiscal year 2004 — which began Oct. 1 — the Office of Inspector General (OIG) of the Department of health and Human Services predicts that it will oust "several thousand" wayward providers and suppliers from federal healthcare programs. The watchdog agency says it also plans to continue its work aiding the Department of Justice in False Claims Act cases, conducting site visits on providers bound by corporate integrity agreements and pursuing other fraud and abuse enforcement measures.

The work plan — essentially a compendium of the agency’s anticipated activities for the coming year — lists dozens of new audits and investigations in the works, from a review of claims for coronary artery stents to a study of whether providers are using modifier –25 appropriately.

To see the work plan, go to this link.

Source: Medical Newswire

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