OIG seeks input to update hospital guidance

The Department of Health and Human Services’ Office of Inspector General (OIG) is seeking recommendations from hospitals in order to update the compliance guidance it first published February 1998. The solicitation for recommendations to revise that guidance follows "recent changes in regulatory requirements and the industry generally," according to the OIG.

"The reimbursement world has changed a lot since they came out with their original guidelines," says Dennis Barry, a partner with Vinson and Elkins in Washington, DC. He points out that cost reimbursement is almost totally irrelevant now, while many other issues have become far more important.

The hospital outpatient prospective payment system (OPPS) is one major change, but there are others too, he adds. For example, the issue of one-day stays is not addressed in the existing guidance but continues to show itself as a major issue confronting hospitals. Specifically, the OIG says it intends to evaluate the impact of the OPPS, which includes a long list of new potential risk areas.

The OIG also noted advanced beneficiary notices, charge description master, coinsurance collections, transitional corridor payments, multiple-procedure discounting, packaging of ancillary services, observation status, readmissions, inpatient-only procedures, medical record documentation, and hospital and physician coding.

The OIG’s solicitation of information was published June 18 in the Federal Register and is available at the OIG’s web site at www.hhs.gov.