OIG to investigate long-term care cost reports

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Nursing home operators and their use of government dollars will come under closer scrutiny, according to details in the new Office of Inspector General's 2008 work plan.

Among its efforts, the OIG will review nursing facility cost reports and evaluate the government's oversight of Medicare expenditures contained in the reports.

"Nursing facility care accounted for 16% of Medicare expenditures in 2005. We will determine the extent to which CMS [Centers for Medicare & Medicaid Services] is monitoring Medicare nursing facility cost reports to ensure compliance with established requirements," the Department of Health and Human Services agency said.

The OIG also will start a new study of Medicare claims submitted by skilled nursing facilities. Its goal is to find out how accurately skilled nursing facilities are using Resource Utilization Groups for reimbursement.

Other new studies will include analyzing Minimum Data Set and resident assessment protocols through provided services. Also, ongoing studies of consolidated billing and possible improper payments, as will as a study of quality of care and corporate compliance programs in nursing homes with corporate integrity agreements, will continue.

To see the OIG report, click on http://oig.hhs.gov/08/Work_Plan_FY_2008.pdf.