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Renal News / Health Care Policy & Politics

Dialysis, transplant part of OIG work plan

October 08, 2012
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The Office of Inspector General's work plan for 2013 will include a review of how well Medicare is monitoring the performance of dialysis facilities, and how the nation’s organ procurement organizations are following reporting requirements.

The work plan is released by the OIG twice a year, and summarizes the OIG’s most significant findings, recommendations, investigative outcomes, and outreach activities in 6-month increments.

"We will review Medicare payments to organ procurement organizations to determine whether payments were correct and were supported by documentation, including whether OPOs correctly reported organ statistics for purposes of proper allocation of costs in their cost reports," the OIG wrote.

For end-stage renal disease, the OIG says it will "assess the performance of oversight functions as well as the complaint processes of dialysis facilities." The agency also plans on looking at Medicare pricing and utilization related to renal dialysis services under the new ESRD bundled payment for dialysis services.

“We will also determine whether Medicare payments under the new ESRD PPS were made in accordance with Medicare requirements," and review payments for ESRD drugs under the new bundled rate system. "We will compare facilities’ acquisition costs for certain drugs to inflation-adjusted cost estimates and determine how costs for the drugs have changed since our last review."

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