2015 OIG Workplan Summary

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It is not sufficient to rely on the physician order to evaluate and treat the patient, to substantiate the services rendered and billed. The 2015 OIG Workplan maintains their objective to reduce the number of false claims submitted by nursing homes for services rendered through rehabilitative clinicians. The licensed clinician has the burden to validate through the evaluation, plan of care and ongoing assessment of the patient why the technical skills provided by the discipline delivering care, is essential to the patient achieving the goals set forth in the care plan. Completion of documentation within the timeframes required, such as recording 30 day summaries at a minimum for Medicare-A beneficiaries and or daily encounter notes when treating