OIG Issues Report on Billing Practices of Skilled Nursing Facilities

In late December 2010, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) published a report entitled Questionable Billing by Skilled Nursing Facilities, Report No. EI-02-09-00202. The OIG Report reexamines alleged issues with skilled nursing facility (SNF) billing identified by the OIG in recent years, including a prior OIG report suggesting that more than a quarter of claims submitted by SNFs under Medicare Part A were not supported by the medical record. By analyzing payment trends among SNFs from 2006 and 2008, the OIG’s more recent study questions whether SNFs are improperly billing for excessive therapy services to obtain increased payments under higher paying therapy resource utilization groups (RUGs) and addresses whether billing practices vary based upon the type of SNF ownership.

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