OIG to Audit Medicare Part B Lab Testing During the Pandemic

Fraudulent and abusive billing of lab services has long been a favorite target of OIG enforcers. And with the unprecedented surge of COVID-19 testing during the public health emergency, it’s hardly surprising that the agency would once more turn its attention to labs. Accordingly, audits of Medicare Part B lab services during the pandemic are among the new items the OIG added to its Work Plan in February. OIG Oversight of COVID-19 Testing This isn’t the first time that the OIG has incorporated review of COVID-19 testing into its Work Plan. Last July, the agency announced plans to look into potential abuses of add-on tests, e.g., to confirm or rule a diagnosis other than COVID-19. In the Work Plan item, the OIG agency said it had “program integrity concerns” related to add-on tests in conjunction with COVID-19, particularly the potential of fraudulent billing for associated respiratory pathogen panel (RPP) tests, allergy tests or genetic tests. Adding to the concern, the OIG explained, was the decision of CMS to temporarily relax the rules requiring an order from the treating physician or non-physician practitioner (NPP) for COVID-19 tests during the public health emergency. Relaxation of physician ordering/NPP rules gives “unscrupulous actors more…