OIG Work Plan survey

Results Overview

Date: 1/12/2007 9:02 AM PST

HCCA would like to focus on Medicare topics from the OIG 2007 Work Plan that are most relevant for our members in the next 12 months. We'd like to know how often you expect to encounter the topic and if you perceive it as an area of high risk for compliance. For more information on each topic, please refer to the OIG Work Plan PDF available at http://oig.hhs.gov/publications/docs/workplan/2007/Work%20Plan%202007.pdf Please rate the relevance of each of the following topics by using this scale: Not a concern = will not face this issue in the next 12 months or it is not a compliance risk area Minor concern = might face this issue, but we do not perceive it as a compliance risk area Moderate concern = high probability we will face this issue, this is a compliance risk area Definite concern = will definitely face this "hot button" issue, this is a major risk area
1. Medicare Hospitals - Hospital Capital Payments
Not a concern 101 35%
Minor concern 110 39%
Moderate concern 47 16%
Definite concern 27 9%
Total 285 100%
2. Medicare-Dependent Hospital Program
Not a concern 148 52%
Minor concern 85 30%
Moderate concern 27 9%
Definite concern 25 9%
Total 285 100%
3. Inpatient Rehabilitation Facility Classification Criteria
Not a concern 125 44%
Minor concern 50 18%
Moderate concern 64 22%
Definite concern 46 16%
Total 285 100%
4. Adjustments for Graduate Medical Education Payments
Not a concern 140 49%
Minor concern 74 26%
Moderate concern 52 18%
Definite concern 19 7%
Total 285 100%
5. Payments for Observation Services versus Inpatient Admission for Dialysis Services
Not a concern 92 32%
Minor concern 58 20%
Moderate concern 79 28%
Definite concern 56 20%
Total 285 100%
6. Nursing and Allied Health Education Payments
Not a concern 134 47%
Minor concern 88 31%
Moderate concern 48 17%
Definite concern 15 5%
Total 285 100%
7. Inpatient Prospective Payment System Wage Indices
Not a concern 83 29%
Minor concern 93 33%
Moderate concern 82 29%
Definite concern 27 9%
Total 285 100%
8. Inpatient Rehabilitation Facility Compliance with Medicare Requirements
Not a concern 114 40%
Minor concern 41 14%
Moderate concern 66 23%
Definite concern 64 22%
Total 285 100%
9. Inpatient Rehabilitation Payments - Late Assessments
Not a concern 124 44%
Minor concern 66 23%
Moderate concern 62 22%
Definite concern 33 12%
Total 285 100%
10. Organ Procurement Organizations
Not a concern 172 60%
Minor concern 61 21%
Moderate concern 36 13%
Definite concern 16 6%
Total 285 100%
11. Inpatient Hospital Payments for New Technologies
Not a concern 83 29%
Minor concern 86 30%
Moderate concern 81 28%
Definite concern 35 12%
Total 285 100%
12. Inpatient Psychiatric Facilities
Not a concern 128 45%
Minor concern 48 17%
Moderate concern 57 20%
Definite concern 52 18%
Total 285 100%
13. Long-Term Care Hospital Payments
Not a concern 173 61%
Minor concern 48 17%
Moderate concern 42 15%
Definite concern 22 8%
Total 285 100%
14. Long-Term Care Hospital Admissions
Not a concern 168 59%
Minor concern 49 17%
Moderate concern 45 16%
Definite concern 23 8%
Total 285 100%
15. Long-Term Care Hospital Classification
Not a concern 184 65%
Minor concern 47 16%
Moderate concern 34 12%
Definite concern 20 7%
Total 285 100%
16. Critical Access Hospitals
Not a concern 174 61%
Minor concern 37 13%
Moderate concern 39 14%
Definite concern 35 12%
Total 285 100%
17. Rebates Paid to Hospitals
Not a concern 70 25%
Minor concern 106 37%
Moderate concern 73 26%
Definite concern 36 13%
Total 285 100%
18. Outpatient Outlier and Other Charge-Related Issues
Not a concern 47 16%
Minor concern 76 27%
Moderate concern 104 36%
Definite concern 58 20%
Total 285 100%
19. Outpatient Department Payments
Not a concern 34 12%
Minor concern 61 21%
Moderate concern 112 39%
Definite concern 78 27%
Total 285 100%
20. Unbundling of Hospital Outpatient Services
Not a concern 38 13%
Minor concern 65 23%
Moderate concern 94 33%
Definite concern 88 31%
Total 285 100%
21. "Inpatient Only" Services Performed in an Outpatient Setting
Not a concern 54 19%
Minor concern 70 25%
Moderate concern 94 33%
Definite concern 67 24%
Total 285 100%
22. Medical Appropriateness and Coding of Diagnosis-Related Group Services
Not a concern 44 15%
Minor concern 46 16%
Moderate concern 106 37%
Definite concern 89 31%
Total 285 100%
23. Medicare Rural Hospital Flexibility Program
Not a concern 199 70%
Minor concern 51 18%
Moderate concern 24 8%
Definite concern 11 4%
Total 285 100%
24. Inappropriate Payments for Interpretation of Diagnostic X-rays in Hospital Emergency Departments (revised)
Not a concern 84 29%
Minor concern 74 26%
Moderate concern 79 28%
Definite concern 48 17%
Total 285 100%
25. Oversight of Specialty Hospitals (revised)
Not a concern 181 64%
Minor concern 61 21%
Moderate concern 28 10%
Definite concern 15 5%
Total 285 100%
26. Medicare Physicians and Other Health Professionals - Billing Service Companies
Not a concern 79 28%
Minor concern 80 28%
Moderate concern 81 28%
Definite concern 45 16%
Total 285 100%
27. Physician Pathology Services
Not a concern 109 38%
Minor concern 98 34%
Moderate concern 57 20%
Definite concern 21 7%
Total 285 100%
28. Cardiography and Echocardiography Services
Not a concern 66 23%
Minor concern 89 31%
Moderate concern 80 28%
Definite concern 50 18%
Total 285 100%
29. Physical and Occupational Therapy Services
Not a concern 59 21%
Minor concern 75 26%
Moderate concern 86 30%
Definite concern 65 23%
Total 285 100%
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30. Payments to Providers of Care for Initial Preventive Physical Examination
Not a concern 95 33%
Minor concern 109 38%
Moderate concern 56 20%
Definite concern 25 9%
Total 285 100%
31. Part B Mental Health Services
Not a concern 109 38%
Minor concern 79 28%
Moderate concern 63 22%
Definite concern 34 12%
Total 285 100%
32. Wound Care Services
Not a concern 69 24%
Minor concern 94 33%
Moderate concern 79 28%
Definite concern 43 15%
Total 285 100%
33. Evaluation of "Incident to" Services
Not a concern 31 11%
Minor concern 88 31%
Moderate concern 91 32%
Definite concern 75 26%
Total 285 100%
34. Potential Duplicate Physical Therapy Claims
Not a concern 85 30%
Minor concern 93 33%
Moderate concern 71 25%
Definite concern 36 13%
Total 285 100%
35. Eye Surgeries
Not a concern 137 48%
Minor concern 75 26%
Moderate concern 56 20%
Definite concern 17 6%
Total 285 100%
36. Place of Service Errors
Not a concern 58 20%
Minor concern 95 33%
Moderate concern 88 31%
Definite concern 44 15%
Total 285 100%
37. Review of Evaluation and Management Services During Global Surgery Periods
Not a concern 74 26%
Minor concern 86 30%
Moderate concern 78 27%
Definite concern 47 16%
Total 285 100%
38. Psychiatric Services Provided in an Inpatient Setting
Not a concern 114 40%
Minor concern 65 23%
Moderate concern 61 21%
Definite concern 45 16%
Total 285 100%
39. Medicare Reimbursement for Polysomnography
Not a concern 125 44%
Minor concern 97 34%
Moderate concern 46 16%
Definite concern 17 6%
Total 285 100%
40. Long Distance Physician Claims Associated with Home Health and Skilled Nursing Facility Services
Not a concern 168 59%
Minor concern 77 27%
Moderate concern 31 11%
Definite concern 9 3%
Total 285 100%
41. Violations of Assignment Rules by Medicare Providers
Not a concern 96 34%
Minor concern 104 36%
Moderate concern 52 18%
Definite concern 33 12%
Total 285 100%
42. Advanced Imaging Services in Physician Offices
Not a concern 148 52%
Minor concern 64 22%
Moderate concern 44 15%
Definite concern 29 10%
Total 285 100%