Review Medicaid Integrity Contractors (MICs) completed 81% of their CMS assignments resulting in potential $282 million in possible recoveries for Jan. 1, 2010, to June 30, 2010, according to a February OIG report...Read More »
CMS’ Recovery Auditors (previously called Recovery Audit Contractors, now associated with the Recovery Audit Program [RAP]), collected nearly $400 million in overpayments from October 1 through December 31, 2011,...Read More »
On August 24, the U.S. Department of Health and Human Services (HHS) announced a one-year delay of ICD-10-CM/PCS implementation. The new deadline is October 1, 2014. (Read the final rule at www.ofr.gov/OFRUpload/OFRData/2012-21238_PI.pdf.)
Fifty-eight percent of claims billed with MS-DRG 246, percutaneous cardiovascular procedure with drug-eluting stent, with MCC or four-plus vessels/stents, were denied by Trailblazer Health Enterprises, LLC, the Medicare Administrative Contractor for Jurisdiction 4(Texas, New Mexico, Colorado,...Read More »
Central line-associated bloodstream infections (CLABSIs) result in an estimated $700 million in additional healthcare costs across the nation, with more than 41,000 people affected in 2009, according to a February 7 CMS...Read More »
Boston’s Beth Israel Deaconess hospital is the latest facility to succumb to investigations regarding potentially inappropriate billing for inpatient services, according to a February 6 article in...Read More »
CMS acting administrator Marilyn Tavenner indicated that the agency could be considering a revision to the ICD-10-CM/PCS implementation timeline during the American Medical Association (AMA) National Advocacy Conference in Washington, DC. Tavenner also indicated that the timeline will be...Read More »