The fourth quarter 2011 Short-Term Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER) is available via QualityNet. This PEPPER release suppresses data regarding “PTCA with Stent” statistics due to problems in the national Medicare claims data warehouse and includes a...Read More »
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 »
