The HHS inspector general's office wants to add more oversight of nursing home discharges and medical equipment payments and recover funds from upcoding.
The office published its annual report of "top unimplemented recommendations" Dec. 15.
These are the three new recommendations appearing on OIG's list this year:
- CMS should take action to prevent inappropriate nursing home discharges through training, by implementing deferred initiatives, and by reviewing current enforcement.
- CMS should improve and implement system edit processes for its durable medical equipment Medicare contractors to prevent overpayments for equipment provided to hospice beneficiaries.
- CMS should monitor data to see which states have lowest levels of blood lead screening tests for children and develop plans to improve rates in underperforming states.
Other OIG recommendations to recover funds and prevent waste include:
- CMS should reevaluate inpatient rehabilitation facility payments in Medicare and establish policies for paying for patients discharged early.
- CMS should seek legislative authority to reform the hospital wage index system.
- The agency should recover $1 billion in overpayments from incorrectly coded diagnoses of severe malnutrition, and review claims susceptible to upcoding.
- CMS should monitor Medicare Advantage plans with disproportionate shares of risk-adjusted payments.
- The agency should develop a strategy to make sure Medicare Part D does not pay for drugs that should be paid for by Part A.
Read OIG's full list of 25 unimplemented recommendations here.