Independent Diagnostic Testing Facilities Facing OIG Scrutiny

In two reports posted August 30, 2011, the Department of Health and Human Services, Office of Inspector General (OIG) announced that many Independent Diagnostic Testing Facilities (IDTFs) in Miami and Los Angeles failed to comply with selected Medicare standards after unannounced site visits in May and June 2010.

An IDTF offers diagnostic services and is independent of a physician’s office or hospital. The selected Medicare standards which the OIG reviewed were that the IDTFs be at the location on file with CMS and to be open during business hours.

In Los Angeles, the OIG found that 46 of the 132 area IDTFs failed to comply with one of the two selected Medicare standards. 24 IDTFs were not at the location on file with CMS. 22 IDTFs were not open during business hours.

In Miami, the OIG found that 27 of the 92 area IDTFs failed to comply with one of the two selected Medicare standards. 23 IDTFs were not at the location on file with CMS. 4 IDTFs were not open during business hours.

As a result of these site visits, the OIG recommended that CMS conduct more unannounced site visits to IDTFs. CMS concurred with the OIG recommendation and stated that it anticipates increasing the frequency of unannounced site visits to IDTFs and will take appropriate administrative actions against the IDTFs identified in the OIG report.

Due to CMS’ stated intention to conduct more unannounced site visits, any IDTF must ensure full compliance with Medicare standards. The attorneys at The Health Law Partners can help ensure full compliance with all Medicare standards.

For assistance with or for more information Independent Diagnostic Testing Facilities or Medicare and Medicaid programs please contact Adrienne Dresevic, Esq., Carey Kalmowitz, Esq., or Daniel B. Brown, Esq. at (212) 734-0128, (248) 996-8510 or (770) 804-4700. More information may also be obtained at the HLP website.