OIG FY 2014 Work Plan Targets Inpatient Admission Criteria, Costs from Defective Devices, More

February 5, 2014 | Strategic Insights for Health System


The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) will investigate new inpatient admission criteria, Medicare costs associated with defective medical devices, salaries included in hospital cost reports, and outpatient evaluation and management services billed at the new-patient rate, among many other areas of potential fraud and abuse being targeted in the coming fiscal year, according to the agency’s Fiscal Year (FY) 2014 Work Plan. OIG’s report on new inpatient admission criteria will determine the impact of these criteria on hospital billing, Medicare payments, and beneficiary payments. This review will also determine how billing varied among hospitals in FY 2014. In another review, OIG intends to analyze Medicare claims to identify the costs resulting from additional utilization of medical services associated with defective medical devices and determine the impact of the cost on the Medicare Trust Fund.

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