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OIG 2011 Work Plan: Evaluation and Management Services

In 2009, Medicare spent nearly one fifth of its Part B payments on Evaluation and Management (E&M) Services. Providers are responsible for ensuring proper coding when submitting their claims. The OIG will review the E&M claims that have been submitted to determine if coding patterns vary by provider. Furthermore, the OIG will examine the “extent of potentially inappropriate payments for E&M services and the consistency of E&M medical review determinations” as a result of receiving multiple claims with identical documentation services. Finally, there will be an evaluation of whether or not the global surgery fee is still appropriate since the global surgery period’s inception in 1992.

For more information, please contact The Health Law Partners, P.C. at (248) 996-8510 or (212) 734-0128 or visit the HLP website.

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