The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) released its 165-page Workplan for Fiscal Year 2012 last month. With respect to hospitals, the OIG’s Workplan continues about 17 “areas of focus” from prior years and adds six new ones. This column will summarize some of the areas that the OIG will be scrutinizing in the hospital sector in the coming year.1
Present on Admission
Medicare requires hospitals to document on their bills all diagnoses when patients are admitted to the facility. Hospitals do not receive additional payments for treating certain conditions that a patient develops during hospitalization that were not present when the patient was admitted. In fiscal year 2008, the Centers for Medicare and Medicaid Services (CMS) began requiring hospitals to submit Present on Admission (POA) indicators with each diagnosis code on their Medicare hospital inpatient claims. These indicators document what conditions were present when the patient was admitted, together with any other conditions that developed during the time the patient was hospitalized.
