CDI Strategies - Volume 15, Issue 55

Note from the ACDIS Director: OIG announces audits of Medicaid inpatient hospital claims for severe malnutrition; ACDIS wants to hear about your experiences

December 16, 2021
Denials & Appeals, Quality & Regulatory

by Brian Murphy

For the last few years, ACDIS has been working with a multiorganizational malnutrition diagnosis, documentation, and coding task force including the American Society for Parenteral and Enteral Nutrition (ASPEN), the Academy of Nutrition and Dietetics (Academy),...Read More »
CDI Strategies - Volume 15, Issue 50

News: Coventry Health Care received half a million dollars in overpayment, latest OIG audit finds

November 11, 2021
Denials & Appeals, News

In its latest round of Medicare Advantage audits, the Office of Inspector General (OIG) found that Coventry Health Care of Missouri, Inc. received $548,852 in...Read More »
CDI Strategies - Volume 15, Issue 33

News: CMS rule restored requiring insurers to return Medicare Advantage overpayments

August 19, 2021
Denials & Appeals, News

Private healthcare insurers who administer Medicare Advantage plans will have to repay overpayments they receive in spite of incorrect diagnoses, according to a Washington, D....Read More »
CDI Strategies - Volume 15, Issue 33

Q&A: 30-day readmission denial appeals

August 19, 2021
Ask ACDIS, Denials & Appeals

Do you appeal many 30-day readmission denials and what is your approach?Read More »
CDI Strategies - Volume 15, Issue 32

News: OIG investigates Aetna in its latest round of audits

August 12, 2021
Denials & Appeals, News

Following a report from the Office of Inspector General (OIG) earlier this year showing an increase of Medicare billing for high-level inpatient stays over the past six years...Read More »
CDI Strategies - Volume 15, Issue 31

News: Government intervenes in six False Claims Act suits against Kaiser Permanente

August 5, 2021
Denials & Appeals, News

The United States government has intervened in six whistleblower allegations that the Kaiser Permanente consortium violated the False Claims Act by allegedly...Read More »
CDI Strategies - Volume 15, Issue 29

News: OIG releases Health Care Fraud and Abuse Control Program FY 2020 Report

July 22, 2021
Denials & Appeals, News

During fiscal year 2020, the federal government won or negotiated more than $1.8 billion in healthcare fraud judgements and settlements, according to the OIG’s fiscal year 2020 Health Care Fraud and Abuse Control Program (...Read More »
CDI Strategies - Volume 15, Issue 28

News: Ohio hospital system received $4.4 million in overpayments, OIG audit finds

July 15, 2021
Denials & Appeals, News

A Medicare hospital provider compliance audit performed by the Office of Inspector General (OIG) found that the Lake Hospital System in Ohio did not fully comply with Medicare billing requirements for 51 of 100 inpatient and...Read More »

Pages