Physicians To Be Affected By Oig's Idtfs And Emtala

By Author: Jaun Paul
Total Articles: 53
Comment this article

Physicians take notice. The OIG's 2010 Work Plan is full of clear enforcement and compliance goals that will certainly affect you.


There are other issues the OIG will look into that may not seem to have much to do with doctors initially. But taking a close look at it will help physician practices gear up for some unexpected compliance issues in the coming year. The key strategies for OIG compliance is therefore preparation.


Independent Diagnostic Testing Facilities (IDTFs) and EMTALA are two issues that feature in this year's Work Plan.


IDTF


According to the Work Plan, the OIG is interested in two areas concerning IDTFs: Services and billing patterns in areas with high concentrations of IDTFs; and compliance with the facilities' Medicare enrollment standards.


The 2006 OIG reviewdetected ...
... several problems pertaining to IDTF. This included noncompliance with Medicare standards and potential improper payments of $71.5 million. In areas with a high density of IDTFs, OIG will look into service profiles, provider profiles, beneficiary profiles and billing patterns.


In a separate category, the OIG says it will inspect whether IDTFs are in compliance with all applicable Federal and State licensure and regulatory requirements for the health and safety of patients, provide comprehensive and correct information on their enrollment applications, and have technical staff on duty with the right credentials to perform tests.


EMTALA Review


The OIG is also planning to review CMS' overnight of hospitals' compliancewith the Emergency Medical Treatment and Labor Act (EMTALA). Physicians may not take notice of this goal, but they should.


According to the Work Plan, a previous OIG review raised alarms about long delays to investigate complaints and inadequate feedback provided to hospitals on alleged violations. OIG plans to identify variations among regions in the number of EMTALA complaints and cases referred to states, examine CMS' methods for tracking complaints and cases, and the like.


We provides the latest developments in Healthcare OIG compliance, and advanced Learning Opportunities about OIG's 2010 Work Plan for healthcare executives and physician billers.