OIG has also posted one new Inspection and one new Audit report to the. Summaries of the reports follow. Selecting the link immediately following the title will take you directly to the full document.
INSPECTION REPORT:
Trends in the Assignment of Resource Utilization Groups (OEI-01-03-00180)
http://oig.hhs.gov/oei/reports/oei-01-03-00180.pdf
In 1998 Medicare began to reimburse skilled nursing facilities using a prospective payment system. In order to determine reimbursement, nursing homes code Medicare residents into 1 of 44 resource utilization groups (RUGs). In 1999, the Balanced Budget Reform Act included a 4 percent across-the-board increase in payments to skilled nursing facilities for fiscal years 2001 and 2002 and a temporary 20 percent increase to 15 RUGs for resident conditions considered medically complex. In the fall of 2000, Congress further adjusted the payment rates under the Benefits Improvement and Protection Act, which also mandated that the Office of Inspector General assess whether payment incentives exist for the delivery of inadequate care. Based on OIG analysis of data from January 1999 to December 2002, minimal shifts occurred in the assignment of resource utilization groups that correspond to legislative payment changes to skilled nursing facilities during this period. As of October 1, 20!
02, all temporary payment adjustments ended, and any payment incentives that may have existed concluded at that time.
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