Audit Plans Outlined
During testimony March 28 before a subcommittee of the House Appropriations Committee, Inspector General June Gibbs Brown described Medicare- and Medicaid-related projects expected to be completed by the end of fiscal year 2001.
Medicare-related projects include the following topics:
- Pneumonia upcoding by hospitals,
- Critical care services in hospitals,
- End-stage renal disease services,
- Compliance program monitoring,
- Impact of the Balanced Budget Act reforms on home health,
- Impact of the implementation of the prospective pricing system on skilled-nursing facilities, and
- Improper hospital discharges and transfers.
Medicaid-related projects include the following topics:
- Outpatient prescription drugs,
- Potentially excessive claims,
- Payments to disproportionate share hospitals, and
- Payments for pharmacy claims from liable third parties.