CMS and the OIG will conduct a two-part study to assess inpatient hospital billing due to unspecified upcoding in hospital billing—either accidentally or intentionally reporting higher severity codes than supported by documentation to increase payment.Read More »
I can still recall in vivid detail our first ACDIS conference back in June of 2008. We had to submit a plan to Caesar’s Palace in Las Vegas to reserve rooms and space and had no prior track record with which to make our forecast.
Two physicians and three nurses were sentenced last week in a $11.3 million Medicare fraud scheme involving false and fraudulent claims for home health services, the OIG...Read More »
As we approach the end of 2018, ACDIS is looking back over its webinar offerings from this year. Starting in January, ACDIS has offered nine webinars covering a wide variety of CDI topics (and we’re planning one more for December on the new malnutrition criteria with Richard Pinson, MD, and...Read More »
DaVita Medical Holdings, a subsidiary of the dialysis company DaVita Inc., will pay $270 million to settle allegations that they incorrectly inflated certain Medicare Advantage reimbursements above the fixed, risk-adjusted rate owed for care.Read More »
The end of last week brought news of a lawsuit that appears to have broad and deep ramifications for the CDI profession. Providence Health & Services, a 34-hospital system headquartered in Renton, Washington, has been hit with a $188.1 million lawsuit for...Read More »
Only months after eClinicalWorks was sued for nearly $1 billion over inaccurate and unreliable data, the OIG fined the software company $132,500 for failing to report patient safety issues with its...Read More »
Last week, CMS announced new initiatives to improve Medicaid program integrity “through greater transparency and accountability, strengthened data, and innovative and robust analytic tools."Read More »
