CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
Q: Our clinical trial claims often hit edits for missing drugs or devices when those are supplied by the trial sponsor and we can't bill for them. We've been manually reviewing these edits. Is there a recommended method for handling these types of edits that's more efficient?
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.
On June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.
This week’s Medicare updates include an OIG review of a hospital’s skewed wage data, a court-ordered explanation on methodology for certain IPPS calculations, a memo on changes to timelines on investigations for deaths associated with restraint or seclusion, and more!
Put CMS’ proposed changes in perspective to see the bigger picture. Comments are due June 24, so hospitals will need to conduct a careful analysis to determine the impact of the proposed changes and submit specific feedback.
