OIG is stepping up audits of small health care providers who bill Medicare.

Tuesday, September 16, 2014

OIG is stepping up audits of small health care providers who bill Medicare. For example, OIG just completed an audit of a physical therapy provider in Illinois who submitted 4,298 claims to Medicare for reimbursement in 2011 that totaled $645,966. Of the 4,298 claims, OIG audited just 100 of them and concluded that 99 out of the 100 sampled did not comply with various Medicare standards. As a result, OIG is demanding that the physical therapy provider reimburse Medicare $634,837! To avoid being forced to reimburse Medicare or Medicaid for claims received, the small physical therapy provider is reminded to follow the standards contained in the Medicare Benefit Policy Manual, chapter 15, ยง 230.