The U.S. Justice Department is investigating several health insurers over whistle-blower allegations that they fraudulently collected millions in Medicare payments by claiming patients were sicker than they actually were.Read More »
by James S. Kennedy, MD, CCS, CDIP, CCDS
CMS plans to announce a complete revision of the CC/MCC structure in next year’s proposed fiscal year (FY) 2019 inpatient prospective payment system (IPPS) rule. CMS notes that over the past several years, there has been a steady increase...Read More »
Information management in EHRs. Implementation and use of clinical decision support. Test result reporting and follow-up. These concerns topped ECRI Institute’s list of patient safety concerns for 2017,...Read More »
CMS approved Performant, the Recovery Audit Contractor (RAC) for Region 1, to begin review activity as of Friday, March 10, according to the RAC Monitor. Read More »
Under the Affordable Care Act (ACA), providers have to recertify their Medicaid reimbursement eligibility. Because of this provision, more than 65,000 providers across 15 states lost their spots on the Medicaid roll, according to...Read More »
Radiation oncology services billed to CMS had a 9.6% improper payment rate in 2015, leading to Medicare improperly pay $137 million for these services, according to a study reported in the January 2016 Medicare Quarterly Compliance Newsletter,...Read More »
