Looking upon Medicare billing and payment of lab services with suspicion is part of the U.S. Department of Health and Human Services Office of Inspector General’s (OIG’s) organizational DNA. So, the fact that audits of Medicare Part B lab services during the pandemic are among the items on the agency’s Work Plan is no surprise. What makes this a man-bites-dog story is that the OIG’s primary concern is whether labs have actually been billing enough for Part B tests since the pandemic began.
The Work Plan item added in February 2021 wonders aloud why more tests were not being performed—specifically, tests for conditions other than COVID-19—in the first year of the pandemic. The “number of non-COVID-19 tests billed for Medicare Part B beneficiaries during the COVID-19 pandemic has decreased compared to the six-month period before the pandemic,” the OIG notes. The agency also expresses a seldom-seen sympathy for labs by acknowledging that “many independent labs have encountered challenges in providing COVID-19 testing.”
As a result, the OIG says it will audit utilization of Medicare Part B lab services during the pandemic, focusing initially on non-COVID-19 testing. Of course, the Work Plan item adds, the agency will also look into “aberrant billing of COVID-19 testing during the pandemic.”