The work plan is an important indicator of the Office of Inspector General (OIG) priorities and informs practices of the areas where they should focus compliance efforts. According to the OIG 2015 work plan that was released at the end of October, only a few new targets have been added. Most of the issues addressed in the work plan are not related to Part B claims. Many of the Part B issues that are addressed are repeat target areas including durable medical equipment, chiropractic, and ambulance claims.
Next year, the OIG will focus on Part B specialties rather than Part B claims in general. Specialties that will receive heightened attention include:
- Claims for personally performed anesthesia services, including those with an AA services code,
- Payments for practice expenses for imaging services,
- Inappropriate and questionable billing by ophthalmologists during 2012,
- Outpatient physical therapy services by independent physical therapists,
- Coding errors on place of service coding for services provided in ambulatory surgery centers and hospital outpatient department, and
- The high cost of diagnostic radiology tests to determine whether they’re medically necessary and the extent to which use has increased for these tests.
More information regarding the OIG work plan can be found at http://oig.hhs.gov/reports-and-publications/archives/workplan/2015/FY15-Work-Plan.pdf.