The Office of Inspector General (OIG) in November released the annual Work Plan, which is designed to ferret out fraud, waste and abuse in the Medicare and Medicaid programs.
Typically, the OIG identifies potential problem areas based on previous small-sample (probed) audits.
The work plan includes one area of particular concern to physicians:
- Medicare Payments for Transitional Care Management (TCM) and Chronic Care Management (CCM)
The OIG will review TCM and CCM payments to ensure compliance with Medicare requirements while hospitals continue to be penalized based on readmission rates of Medicare patients and physicians struggle with care coordination for the same population.
For additional assistance, members may contact KMA Medical Business Advocacy at firstname.lastname@example.org.