A Texas-based healthcare company reached a voluntary resolution agreement with HHS and the Office for Civil Rights (OCR) on January 16 regarding allegations that it had failed to provide effective communication to hearing-impaired patients.
The American Hospital Association (AHA) and the Association of American Medical Colleges (AAMC) recently filed a lawsuit against the Department of Health and Human Services (HHS) for continuing to reduce payments for hospital outpatient services provided in grandfathered, off-campus provider-based departments (PBD) in the fiscal year 2020 OPPS final rule.
Q: A physician performed a pleural catheter flush using saline with manual clearance of clots under ultrasound guidance. Should we bill an E/M code for an outpatient office visit or report this using other CPT codes?
Q: The Office for Civil Righs (OCR) has settled its first case related to its Right of Access initiative. What is important to know about this from a security standpoint? Where are common security missteps with releasing information to patients upon request?
HHS’ Health Resources and Services Administration (HRSA) should step up oversight of hospitals participating in the 340B drug discount program, the U.S. Government Accountability Office (GAO) recommended in a recent report.
Findings from a December Office of Inspector General (OIG) report show that CMS based an estimated $2.7 billion in risk-adjusted payments on chart review diagnoses that Medicare Advantage organizations (MAO) didn’t link to specific services. Their findings highlight concerns about the validity of payment data submitted to CMS.
Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?
