This week’s Medicare updates include a decision memo for an ambulatory blood pressure monitoring NCD, another extension of enforcement discretion for the laboratory date of service exception policy, a fact sheet on proper billing processes for DMEPOS items delivered to inpatients, and more!
Accountable care organizations (ACO) avoid downside risk contracts even though the number of ACO contracts and ACOs with multiple contracts have grown, according to a recent study. The study authors suggest that stronger incentives to take on downside risk are necessary to ensure the success of the ACO model.
Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures
In 2013, “Guidelines for Achieving a Compliant Query Practice,” a collaboration between AHIMA and ACDIS, was published. It has served as the industry guideline for the establishment of best practices surrounding queries. The 2019 update reinforces the information set forth in the preceding practice briefs while also introducing some newer guidelines reflective of today’s healthcare environment.