Compliance

CMS clarified billing instructions for off-campus hospital outpatient services and provider-based departments (PBD) in its most recent update to its novel coronavirus billing

Q: What guidelines do the Office of Inspector General (OIG) expect to see in our laboratory billing policies?

This week’s Medicare updates include guidance on data to include when reporting COVID-19 test results to the CDC, recommendations on re-opening facilities for non-emergent care, updates to the OIG work plan, and more!

Q: What services will require prior authorization from Medicare starting July 1 and how do we submit prior authorizations to Medicare?

CMS updated its Medicare billing FAQs to include new questions related to National Coverage Determinations (NCD) during the novel coronavirus (COVID-19) public health emergency (PHE).

Determine the impact of new regulatory relief for hospitals regarding outpatient services and telehealth originating site services provided to patients at alternate locations, including their homes.

Q: How can we decide what risk areas should be the focus of auditing and monitoring?

CMS packed some potentially game-changing proposals into a pared-down fiscal year (FY) 2021 inpatient prospective payment system (IPPS) proposed rule. Understand how these proposals could have far-reaching implications for hospitals.

Q: What are the Office of Inspector General's (OIG) recommendations for policies and procedures related to billing?

When provided with information on the threat and degree of risk, senior leadership can evaluate the information and make reasonable judgments about what to do. Use this sample quarterly report to the board of trustees to keep the board and executives apprised of the changing risk profile.