OIG plans to scrutinize skilled nursing facilities' Medicare Part A claims

Share this article:
HHS Inspector General Donald Levinson
HHS Inspector General Donald Levinson

Skilled nursing operators can expect to see a new government report on Medicare Part A billing practices released in 2014, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

The work plan identifies five OIG reviews related to nursing homes. The review of SNFs' Part A billing is labeled as a “new” project, meaning it did not appear in the previous work plan.

The Part A review will analyze variations in SNF billing patterns for selected years, the work plan states. The federal investigators are focusing on Part A billing in light of previous reports, the plan notes. Some of these reports found potentially inappropriate increases in the highest codes for therapy. The work plan also notes that one-quarter of SNF Part A claims in 2009 were erroneous, resulting in $1.5 billion in inappropriate payments.

The inspector general's office also expects to release reports this year on questionable Part B billing, the verification process for deficiency correction plans, and the frequency of potentially preventable hospitalizations of SNF residents, according to the plan. All these projects are described as currently in progress, and were included in the previous work plan.

Long-term care providers and others in the field have said they anticipate generally heightened scrutiny from regulators in 2014.

Click here to access the complete OIG work plan, released Friday.

Share this article:

More in News

Long-term care continues to lead in deal volume and value: PwC report

Long-term care continues to lead in deal volume ...

Long-term care bucked healthcare industry trends with strong merger and acquisition activity in the second quarter of 2014, according to newly released data from professional services firm PricewaterhouseCoopers.

Empowering nurse practitioners could reduce hospitalizations from SNFs, study finds

Granting more authority to nurse practitioners is associated with reduced hospitalization of skilled nursing facility residents, according to recently published findings.

Pioneer ACO drops out of program, despite reductions in skilled nursing utilization

A California healthcare system has become the latest dropout from the Pioneer Accountable Care Organization program, despite reducing skilled nursing facility utilization and improving its readmission rates. Sharp HealthCare announced its decision in a quarterly financial statement released Tuesday.