The U.S. Department of Health and Human Services Office of Inspector General (OIG) will open new studies regarding Medicare Part B imaging payments and the appropriateness of many emergency department scans.
According to the Reston, VA-based American College of Radiology (ACR), the OIG Fiscal Year 2010 Work Plan lists healthcare arrangements the office believes cost too much money or could violate federal fraud and abuse laws. OIG plans to examine the practice expense components of selected imaging services, including the equipment utilization rate and whether it reflects current industry practice.
ACR is cautioning radiologists and their staffs to properly document the medical necessity of and correct code for their services.
Additionally, OIG will continue its anticipated review of whether Medicare payments for emergency department x-rays and interpretations are appropriate. Other projects include an ongoing examination of services and billing patterns in locations with a high density of independent diagnostic testing facilities.
OIG also will start inspecting the degree to which data and safety monitoring boards assess safety data in clinical trials. ACR is recommending that its members who participate in clinical trials discuss the role of such boards with their institutions.
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Does new OIG opinion create preauthorization loophole? October 7, 2008
OIG won't penalize rural hospital for free radiology reports, January 11, 2008
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