News | October 09, 2009

OIG to Review Radiology Payments, Appropriateness

October 9, 2009 - The U.S. Department of Health and Human Services Office of Inspector General (OIG) will open new studies regarding Medicare Part B imaging payments and appropriateness of many emergency department scans according to the recently released OIG Fiscal Year 2010 Work Plan, reported the American College of Radiology.

OIG functions under Congress’ mandate to review healthcare-related programs and operations. The Work Plan is the OIG's annual "playbook" of upcoming investigations, audits, and reports. Its Work Plan lists health care arrangements it believes cost too many dollars or could violate federal fraud and abuse laws. ACR/ACRA members who render patient care in the areas listed in the Work Plan should not expect an immediate knock on their office door from the OIG. However, it could happen, and to be prepared, radiologists and their staffs should properly document the medical necessity of and correctly code for their services.

OIG plans to examine the practice expense components of selected imaging services, including the controversial equipment utilization rate — does it reflect “current industry practice?” The Radiology Business Management Association recently published a study confirming that the actual equipment utilization rate nationwide is only 54 percent — well below the 75 percent assumption called for in House health care reform legislation.

Additionally, OIG will continue its anticipated review of whether Medicare payments for emergency department X-rays and interpretations are appropriate. Other notable projects include an ongoing examination of services and billing patterns in locations with a high density of Independent Diagnostic Testing Facilities (IDTFs).

OIG also will start inspecting the degree to which data and safety monitoring boards assess safety data in clinical trials. ACR/ACRA members who participate in clinical trials should discuss the role of such boards with their institutions.
OIG's 2010 Work Plan

For more information:

Related Content

Patient Complexity, Subspecialization Impact List Prices for Radiologists' Services
News | Business | August 15, 2017
A new study by the Harvey L. Neiman Health Policy Institute finds that patient condition complexity and...
Upcoming radiology conferences, meetings and events.
News | August 14, 2017
ITN maintains a comprehensive listing of radiology specialty meetings on its website at ...
ACR Establishes Education Committee for Patient- and Family-Centered Care
News | Patient Engagement | August 09, 2017
Members of the new Education Committee of the American College of Radiology (ACR) Commission on Patient- and Family-...
ACR Annual Conference on Quality and Safety Offers Strategies for Radiology Practices
News | Business | August 08, 2017
The American College of Radiology (ACR) Annual Conference on Quality and Safety, scheduled for Oct. 13-14 in Boston,...
Sponsored Content | Videos | Business | July 28, 2017
Angelic McDonald, MSRS, CRA, FAHRA, regional director of imaging, Baylor Scott & White Health and the president-e
Radiation dose tracking in medical imaging is helping increase patient safety by lower X-ray doses.
Feature | Radiation Dose Management | July 26, 2017 | Dave Fornell
Patient X-ray radiation exposure from medical imaging has been a hot topic in radiology the past few years and has pr
Radiologists Seek Greater Involvement in Patient Care
News | Patient Engagement | July 20, 2017
Despite time and workload constraints, radiologists are looking for ways to become more directly involved in the care...
ACR Updates Radiation Oncology and Medical Physics Guidance With ASTRO and AAPM
News | Radiation Dose Management | July 19, 2017
July 19, 2017 — The American College of Radiology (ACR) recently collaborated with professional medical societies to
SIIM Recognizes Innovators in Medical Imaging Informatics at 2017 Annual Meeting

Accepting the award on behalf of Arterys is Julia Geer shown with SIIM Chair Dr. Paul Nagy (left), and Innovation Challenge Co-Chair Dr. Ram Chadalavada (right)

News | Analytics Software | July 19, 2017
During the Society for Imaging Informatics in Medicine (SIIM) 2017 general closing session held in Pittsburgh, Fabien...
Overlay Init