Physicians will have their day under the microscope of HHS' inspector general's office, according to the agency's 1999 work plan.
That includes a planned probe into physician billing records that could be the next nationwide fraud initiative.
According to the work plan released by the agency earlier this month, federal investigators will begin their investigation in one unnamed state, reviewing the billing records to identify overpayments by Medicare or Medicaid.
"Should we detect significant problems in this state, we will expand the review to include other geographical areas and other types of providers," the plan said.
Project Bad Bundle, which looks at how hospitals bill Medicare for certain laboratory tests, also began in one state, Ohio, and was later rolled out to several other states.
While the inspector general pursues the physician billing probe, agents will track whether the physicians use any automated encoding software to prepare their Medicare billings. The software, according to the plan, may increase the chance of billing errors. "Results of this work may lead to further reviews," the plan said.
The agency will also continue its Physicians at Teaching Hospitals (PATH) probe, which looks at how teaching hospitals bill Medicare, and its review of physician incentives in managed-care contracts.
Federal investigators aren't just looking at physicians.
They will look at durable medical equipment suppliers to see if they are submitting duplicate bills to both DME regional carriers and regional home health intermediaries.
On the managed-care side, HHS will conduct a review to determine if HMOs should be held accountable for investment income they earn on Medicare funds before those funds are used to pay for services to enrollees.
The inspector general also expects the number of "patient dumping" cases it investigates to increase.
A 1986 federal law prohibits patient dumping, or denying basic medical screenings to emergency patients because they lack the ability to pay. The law also prohibits transferring medically unstable patients for economic reasons.
Between January and July, the government settled 34 patient dumping cases for a total of $983,000.
In fiscal 1999, which began Oct. 1, the inspector general expects to handle about 50 patient dumping cases.