The OIG recently released its semi-annual report.  For the first half of 2013 the OIG has identified $3.8 billion in expected recoveries which includes $521 million in audit receivable and $3.28 billion in investigative receivables.

The report also identifies the most at-risk services related to the recoveries.  These areas include:

• Improper billing of prostate cancer drugs, Herceptin and Amend
• Improper reporting of present on admission (POA) indicators
• Skilled nursing and therapy services without appropriate plans of care and unnecessary services for terminal patients
• Billing for services rendered to ineligible beneficiaries
• Misreporting of diagnosis codes to improperly obtain coverage/payment for services

To access the publication go to the following link:  http://oig.hhs.gov/reports-and-publications/archives/semiannual/2013/SAR-S13-Final.pdf

HC Healthcare Consulting has a team comprised of consultants Certified in Healthcare Compliance along with certified coders, certified fraud examiners, statisticians and physician consultants.  We recommend reviewing the OIG’s report in its entirety and conducting audits of the identified risk areas that are applicable to your organization.  HC Healthcare Consulting is available to assist you with all of your auditing, education and corrective action needs.

DISCLAIMER:  This post contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations given is general and specific questions should be directed to professional counsel.