Physicians to be affected by OIG’s IDTFs and EMTALA

Physicians take notice. The OIG’s 2010 Work Planbeneficiary profiles and billing patterns.
is full of clear enforcement and compliance goals thatIn a separate category, the OIG says it will inspect
will certainly affect you.whether IDTFs are in compliance with all applicable
There are other issues the OIG will look into that mayFederal and State licensure and regulatory
not seem to have much to do with doctors initially. Butrequirements for the health and safety of patients,
taking a close look at it will help physician practicesprovide comprehensive and correct information on
gear up for some unexpected compliance issues in thetheir enrollment applications, and have technical staff
coming year. The key strategies for OIG compliance ison duty with the right credentials to perform tests.
therefore preparation.EMTALA Review
Independent Diagnostic Testing Facilities (IDTFs) andThe OIG is also planning to review CMS’ overnight
EMTALA are two issues that feature in this year’sof hospitals’ compliancewith the Emergency
Work Plan.Medical Treatment and Labor Act (EMTALA).
IDTFPhysicians may not take notice of this goal, but they
According to the Work Plan, the OIG is interested inshould.
two areas concerning IDTFs: Services and billingAccording to the Work Plan, a previous OIG review
patterns in areas with high concentrations of IDTFs;raised alarms about long delays to investigate
and compliance with the facilities’ Medicarecomplaints and inadequate feedback provided to
enrollment standards.hospitals on alleged violations. OIG plans to identify
The 2006 OIG reviewdetected several problemsvariations among regions in the number of EMTALA
pertaining to IDTF. This included noncompliance withcomplaints and cases referred to states, examine
Medicare standards and potential improper paymentsCMS’ methods for tracking complaints and cases,
of $71.5 million. In areas with a high density of IDTFs,and the like.
OIG will look into service profiles, provider profiles,