Medicare Compliance & Reimbursement

OIG discovered inconsistent billing for global eye surgery and believes adjustments could save CMS $97.6 million. When the OIG talks not everyone listens, according to a new report. The OIG makes hundreds of recommendations each year, advising practices and carriers to tighten up documentation, correct their modifier use, or implement other programs. On March 16, the OIG released its "Compendium of Unimplemented Recommendations," which revealed that practices and facilities have ignored many OIG suggestions. Case in point: In 2005, the OIG found that global surgery fees for eye surgeries "did not reflect the number of E/M Services that physicians provided to beneficiaries during the global periods because CMS had not adjusted or recently adjusted the RVUs for most of the global surgery codes," the new report notes. Specifically, out of 300 claims sampled, physicians provided fewer E/M services than were included in 201 of the global surgery fees, and provided [...]