The Office of Inspector General (OIG) is planning to audit hospital inpatient claims for compliance with the 2-midnight rule, according to a recent update to its Work Plan.
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)?
CMS extended the timeline for organizations to repay payments received under its Accelerated and Advance Payment program, according to a fact sheet released October 8.
The discovery of an overpayment raises serious questions about compliance requirements. Understand your organization’s reporting obligation and appropriate methods for determining overpayments.
Organizations that received Provider Relief Fund payments of more than $10,000 will be required to report information on how PRF payments were used as well as expenses related to the novel coronavirus that were not reimbursed (COVID-19), according to new HHS guidance.
UnitedHealthcare’s (UHC) plan to require in-network, freestanding and outpatient laboratory claims to contain a unique code for most lab testing services is poorly timed and poses significant implementation hurdles, the American Hospital Association (AHA) said.
