May 20, 2019
News & Insights

Q: Does this new policy apply to traditional Medicare only or does it also apply to Medicare Advantage?

May 15, 2019
News & Insights

HHS failed to meet targeted improper payment reductions for Medicaid and the Children’s Health Insurance Program and has not implemented a required recovery audit plan for Medicare Advantage, according to an Office of Inspector General (OIG) report.

May 13, 2019
News & Insights

Q: What is the deadline for refunding Medicare overpayments?

May 6, 2019
News & Insights

Q: Where can I find the most recent list of add-on code edits? How often is it updated?

May 1, 2019
HIM Briefings

The Office of Inspector General is stepping up audits of inpatient rehabilitation facility (IRF) claims. Use these expert tips to ensure your facility is coding and billing correctly for these services.

April 12, 2019
News & Insights

CMS released a bulletin April 10 on behalf of HHS seeking providers to participate in a volunteer Provider Pilot Program to test the process for reviewing compliance with its HIPAA Administrative Simplification rules.

April 10, 2019
News & Insights

Representatives from CMS and the Office of Inspector General (OIG) discussed hot topics and focus areas at HCCA's 2019 Compliance Institute in Boston, including developing interactive documentation checklists, potential changes to Stark Law this year, and methods to address the high rate of coding and documentation errors on inpatient rehabilitiation facility (IRF) claims.

March 13, 2019
News & Insights

A proposed rule from HHS’ Office of the National Coordinator for Health Information Technology (ONC) could mandate the publication of prices negotiated between payer and provider organizations as well as detailed information about Medicare reimbursement, DRG prices, and bundled prices.

February 27, 2019
News & Insights

Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.

February 20, 2019
News & Insights

CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.

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