The complexity and competitiveness of today’s business environment require that organizations have early warning systems to identify times when they face certain risks. Compliance officers should be active participants in the organization’s risk assessment process.
Q: For the purposes of determining a Medicare overpayment, should claims that we are uncertain whether they were appropriate be included? Is this defined under the False Claims Act (FCA)?
What your patients don’t know may hurt them. Low health literacy is a problem that affects many patients. They might struggle to understand prescription labels or dosing directions. They may lack a basic understanding of their condition. Even highly educated people might have difficulty understanding medical information and instructions, which limits their ability to participate effectively in their care.
Q: CMS created a new MS-DRG for chimeric antigen receptor T-cell (CAR-T) therapies in the fiscal year (FY) 2021 IPPS final rule. Which ICD-10-PCS codes group to this new MS-DRG and does it qualify for an additional new technology add-on payment?
This week's note from the instructor discusses the latest interim final rule with comment (IFC) and its provisions concern vaccines, payments for new COVID-19 treatments, and more.
