The Office of Inspector General (OIG) Work Plan for Fiscal Year (FY) 2015 describes activities that the OIG plans to initiate or continue in FY 2015. 

 Medicare Part A billing by skilled nursing facilities

OIG will describe changes in SNF billing practices from FYs 2011 to 2013.  Prior OIG work found that SNFs increasingly billed for the highest level of therapy even though beneficiary characteristics remained largely unchanged.  OIG also found that SNFs billed 25% of all 2009 claims in error; this erroneous billing resulted in $1.5 billion in inappropriate Medicare payments. CMS has made substantial changes to how SNFs bill for services for Medicare Part A stays.

Remember to  review your current billing data for trends outside of the norm for your organization. 

 

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