Training Programs
Audits & Assessments
Regulatory MonitoringMay 4-11 Issuances: OIG releases reports, CMS proposes decision memo, and more
OIG issues review of oxaliplatin billing at Providence Alaska Medical Center
On May 8, the OIG issued a review of oxaliplatin billing at Providence Alaska Medical Center for calendar year 2005. The OIG found that Providence Alaska billed Medicare for an incorrect number of service units for one oxaliplatin outpatient claim and received an overpayment of approximately $31,000.
OIG issues review of separately billed lab tests paid by National Government Services, Inc., for ESRD beneficiaries
On May 6, the OIG released a review of separately billed lab tests paid by National Government Services (NGS), a Medicare fiscal intermediary, for laboratory tests that dialysis facilities provided to end-stage renal disease (ESRD) beneficiaries. The OIG estimated that NGS overpaid dialysis facilities $3.9 million for laboratory tests provided to ESRD beneficiaries during calendar years 2004-2006.
CMS issues proposed decision memo for pharmacogenomic testing to predict warfarin response
On May 6, CMS published a proposed decision memo in which it proposed that pharmacogenomic testing to predict warfarin responsiveness is covered only when provided to Medicare beneficiaries who are candidates for anticoagulation therapy with warfarin and only then in the context of a prospective, randomized, controlled clinical study when that study meets certain standards.
View the proposed decision memo.
Frequently asked questions
Last week, CMS released several new/updated frequently asked questions (FAQ) last week related to Medicare fee-for-service payment, coding, and billing.
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