April 2009 Client Newsletter

Medicare Deductibles

Amazingly this year, we are STILL seeing patients meeting their Medicare deductibles as recent as today, April 1, 2009 (not an April Fool’s joke!). This is by far the latest in the calendar year we have seen in our 19 years of business.


OIG WOrk Plan 2009

Each year the OIG publishes its Work Plan for the coming year & CPB reproduces the relevant targets for our clients. The mission of the Office of Inspector General (OIG) is to protect the program integrity of the Department of Health and Human Services (HHS). In fulfilling that mission, the OIG must:
· Conduct and supervise audits and investigations;
· Prevent and detect fraud and abuse;
· Promote economy, efficiency and effectiveness; and
· Inform HHS and Congress about deficiencies and problems.

That mission leads the OIG to conduct a comprehensive review each year to identify potential problem areas and vulnerabilities in the HHS programs. Those areas deemed most worthy of follow up are then included in their annual Work Plan and used to focus OIG activities. You may find the full report at:
www.oig.hhs.gov/publications/docs/workplan/2009/WorkPlanFY2009.pdf

Relevant 2009 OIG Items:
Evaluation and management services during global periods: The OIG will review the number of E&M services provided since global periods were established in 1992 to insure that E&M services were not billed separately.

Outpatient physical therapy services provided by independent therapists: Focusing on services provided by independent therapists with high utilization (including improper use of Therapy Caps), the OIG will ensure that federal guidelines are followed.

Patterns related to high utilization of ultrasound services: In high areas of ultrasound utilization, the OIG will investigate medical necessity.