Which of the following would NOT be expected to fall under the responsibility
or oversight of an organization's compliance committee?
✓ Recommending a specific merit increase in pay for employee's
adherence to the code of conduct
Beginning November 2019, the OIG stated Medicare payment to physicians
for Stelara have increased significantly and will study the payments to
determine if there is evidence of improper billing by the physicians. Where is
information regarding potential reviews found?
✓ OIG Work Plan
An infectious disease provider has been notified by the MAC (Medicare
Administrative Contractor) in his region that the data indicates he is billing
level 99244 more frequent than other providers in the same specialty and
geographic region. The provider requests you audit a sample of his claims
that were coded as 99244 to determine if he is coding appropriately. What
supporting references will you need to conduct the audit?
Master01 | October, 2024/2025 | Latest update
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