Discharges are a common place for lapses and failures to occur, but when they involve patients suffering from mental illness or substance abuse, they can be even more challenging. Although these complex patient cases may present sizable hurdles, it’s important that facilities take measures to ensure discharges in these instances follow both federal and state guidelines and help protect vulnerable patients whenever possible.
This week’s note discusses drug coverage available under Parts A, B, and C, and it looks at ways Medicare Part D closes some of the gaps in Medicare coverage for prescription drugs.
Cardiac device credits came under scrutiny in an Office of Inspector General report that found all 210 hospitals audited failed to adjust claims to reflect certain cardiac device manufacturer credits, leading to $4.4 million in overpayments from CMS.
In today’s uncertain regulatory environment, establishing an internal audit process is more important than ever to ensure proper billing and reimbursement. Follow these eight steps to establish an efficient internal audit and compliance program.
This week’s Medicare updates include a special edition MLN Matters article on billing requirements for OPPS providers, an updated OIG work plan, a final decision memo for an NCD on genetic testing for cancer patients, and more!
