Law enforcement officials in Texas, Florida, and New York recently announced plea agreements and fines involving the billing of an unapproved prescription drug and Medicare fraud.
Recovery Auditor overpayment and underpayment statistics are released by CMS at the close of each fiscal year (FY) quarter, and with FY 2012 in the books, CMS has published its year-end improper payment figures. In FY 2012, the numbers continued to ascend, as CMS more than doubled its total correction amount from the previous year.
Physician documentation must include sufficient detail to ensure that case managers can accurately estimate LOS, says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent health information management consultant in Madison, Wis.
Successful programs to reduce preventable hospital readmissions range from the transitional care model created by Mary Naylor, PhD, FAAN, RN, a nurse researcher at the University of Pennsylvania, to Project RED, created by the Commonwealth of Massachusetts. Kathleen Heery, MS, RN, CCM, and Cheryl Pacella, DNP(c), HHCNS-BC, CPHQ, the homecare consultant and quality advisor at CAP Consulting, LLC, discussed the secrets to their success during "Reducing Readmissions by Improving Transitions in Care," an HCPro webcast.
