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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
The Office of Inspector General released a report examining NASA's management of its Earth science portfolio that includes Earth-orbiting satellites used to collect information on weather, climate, and natural phenomena such as earthquakes, droughts, and wildfires.
The City of New York, NY, Implemented Policies That Did Not Always Ensure That Community Development Block Grant Disaster Recovery Funds Were Disbursed in Accordance With Its Action Plan and Federal Regulations
With respect to Medicaid patient days, Wisconsin Physicians Service (WPS) did not properly settle Medicare cost reports submitted by Indiana hospitals for Medicare disproportionate share hospital (DSH) payments in accordance with Federal requirements. The 48 selected providers improperly claimed a total of 14,325 Medicaid patient days on their Medicare cost reports, resulting in DSH overpayments totaling $6.1 million. These improper claims included both unallowable and unsupported patient days and involved separate Child Health Insurance Program (S-CHIP) recipients, Aid to Residents in County Homes (ARCH) recipients, 590 Program recipients, and dual eligibles.
Claims for outpatient physical therapy services provided by a physical therapy practice (the practice), located in Yuba City, California, did not comply with Medicare requirements. Specifically, of the 100 beneficiary days in our random sample, the practice properly claimed Medicare reimbursement for 36 beneficiary days. However, the practice improperly claimed Medicare reimbursement for the remaining 64 beneficiary days, consisting of 62 beneficiary days that had therapy services that were not medically necessary and 2 beneficiary days that did not meet Medicare documentation requirements. On the basis of our sample results, we estimated that the practice received at least $583,000 in unallowable Medicare reimbursement for outpatient physical therapy services that did not comply with Medicare requirements.
