Archive for the ‘News’ Category

New Website
Posted on 09.24.2012 Under News

Welcome to our newly designed website. Be sure to check back for more things to come.

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The OIG 2012 Work Plan Will Be Reviewing Modifiers Used During The Global Surgical Period
Posted on 04.11.2012 Under News

The OIG looking for improper payments made on Evaluation and Management (E&M) services is nothing new. This year’s Work Plan includes several items on E&M services, including services made during the global surgical period. New to this year they will also be looking at the modifiers used on E&M services performed during the global period.

 

According to the Work Plan “Prior OIG work has shown that improper use of modifiers during the global surgery period resulted in inappropriate

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CMS Postpones New POS Policy
Posted on 04.04.2012 Under News

In late March CMS announced that it was postponing the effective date for it’s new national policy regarding POS coding assignments. Transmittal 2435 delays the effective date from April 2nd 2012 to October 1st 2012.

 

The Transmittal revises and clarifies how POS codes are assigned. In the past the policy was to report the POS code for where the physician physically was when performing the services, under the new policy the POS code for where the face-to-face encounter was perform is to be reported. In cases where there was no face-to-face encounter, such as the professional component of diagnostic services, the POS code for where the technical component of the service was provided is to be reported.

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Documentation Isn’t The Only Thing Under Scrutiny
Posted on 04.04.2012 Under News

State and federal governments are using advanced technology to find suspicious billing patterns that would indicate upcoding or unbundling, and when they find suspicious patterns, they aren’t just looking at the documentation.

 

MedStar Health System’s Good Samaritan Hospital agreed to pay $793,548 to settle allegations that it submitted false claims to the to federal benefit programs from 2005-2008. They deny any wrongdoing and have released a statement saying the hospital “is committed 

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Greg Demske Appointed to replace Lewis Morris as OIG Chief Counsel
Posted on 04.03.2012 Under News

From the HHS OIG announcement:

 

Daniel Levinson, Inspector General for the Department of Health and Human Services, announced that effective today, he has appointed Greg Demske Chief Counsel to the Inspector General, following the retirement of Lewis Morris on April 1.

 

“Greg’s extensive experience here at OIG, coupled with his expertise on a wide range of legal and programmatic issues, makes him highly qualified for this position,” said Levinson.

 

Demske will oversee a staff of 75 professionals who provide a full range of legal services to the Inspector General and OIG. These services include guidance on personnel matters; advice on the legal sufficiency of OIG’s audits and evaluations; assistance in the investigation and resolution of health care fraud cases; and issuance of compliance program guidance, advisory opinions and other assistance to the health care industry.

 

Demske began his tenure with HHS in September 1990 and has served as Assistant Inspector General (AIG) for Legal Affairs since 2005

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