News: OIG adds CMS overpayment collections to its work plan

CDI Strategies - Volume 12, Issue 20

The Office of Inspector General (OIG) will scrutinize how CMS collects overpayments, according to a recent update to its Work Plan.

Although the OIG conducts audits related to Medicare payments, CMS is responsible for collecting those overpayments identified and agreed upon in the OIG’s audit reports. However, the OIG is looking to collect data to determine how CMS goes about collecting those funds, Revenue Cycle Advisor reported.

This isn’t the first time the OIG voiced concerns about CMS’ ability to recapture overpayments. In a 2012 OIG report, Obstacles to Collection of Millions in Medicare Overpayments, the OIG found that as of October 2010 CMS had not collected the majority overpayments the OIG identified in 2007-2008 or the first six months of 2009.

To make matters worse, CMS was not able to verify that it had actually collected the amount it said it collected at that time, according to Revenue Cycle Advisor.

More recently, the OIG reviewed overpayment collections for 2014-2016. During that period, the OIG identified $648 million in overpayments, and CMS agreed to collect $566 million. Using that data, according to Revenue Cycle Advisor, the OIG will investigate whether CMS collected the agreed-upon amount and whether CMS has followed the corrective actions the OIG recommended in its 2012 report on CMS overpayments collections.

Editor’s note: This article was originally published on Revenue Cycle Advisor. To learn about how you can use the OIG Work Plan to focus CDI efforts, click here.

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