Part A claims under scrutiny

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Government investigators will issue a report on skilled nursing facilities' Medicare Part A billing practices later this year, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

The review of Part A billing is labeled as a “new” project, meaning it did not appear in an earlier work plan. It is one of five projects related to nursing homes in the 2014 plan. 

The Part A review will analyze variations in SNF billing patterns, the work plan states. Previous reports have identified issues with Part A billing, such as questionable upticks in the highest codes for therapy, the plan claims. It also notes that erroneous SNF Part A claims in 2009 resulted in $1.5 billion in inappropriate payments.

The OIG also expects to release reports this year on questionable Part B billing practices, the verification process for deficiency correction plans, and potentially preventable hospitalizations of SNF residents, according to the plan. 

These projects were included in the previous work plan.


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