In a terse exchange of communication and reports this week, the HHS and American Hospital Association (AHA) addressed allegations that increased use of electronic health records may lead to increased amounts of Medicare billing fraud.
“[T]here are troubling indications that some...Read More »
In the recently released 2013 OPPS proposed rule, CMS issued a request for comments that suggests that the agency is ready to hear new ideas when it comes to the guidance surrounding the definition of inpatient. Specifically, CMS is asking for comments on defining inpatient at a specific period...Read More »
RAC denials rose by 24% over the previous quarter, according to the August 22 RACTrac survey results from the American Hospital Association (AHA). Hospitals cite medical necessity denials as the primary target with a majority of...Read More »
CMS recently redesigned its Hospital Compare website to enhance navigation capabilities for users. CDI specialists can use Hospital Compare to review their facility’s status on certain quality measures such as readmissions, infections, and other measures. Using the site during physician...Read More »
A recent Office of the Inspector General report found PacifiCare of Texas received $115 million in CMS overpayments. The OIG reviewed 100 sample cases and found 43 claims with incorrect payments. According to the report,...Read More »
Observation services increased 34% from 2007 to 2009, “from an average of 86.9 observation stay events per 1,000 inpatient admissions per month in 2007 to 116.6 in 2009,” according to a June article in the Journal...Read More »
