On Friday, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Work Plan for fiscal year 2015. This plan summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond, according to the department.
The dentals areas the OIG will focus on include outpatient dental claims by hospitals, inappropriate billing for dental services for children, and access to pediatric dental care for children enrolled in Medicaid.
The report notes that the OIG will "review Medicare hospital outpatient payments for dental services to determine whether such payments were made in accordance with Medicare requirements." Current OIG audits have indicated that hospitals received Medicare reimbursement for noncovered dental services, resulting in significant overpayments.
The OIG will also "review billing patterns of pediatric dentists and their associated clinics in selected states" and describe the extent to which children enrolled in Medicaid received dental services in these states. In recent years, a number of dental providers and chains have been prosecuted for providing unnecessary dental procedures and causing harm to Medicaid children.
For more information, the plan can be accessed on the OIG website.
