Anne Arundel Medical Center in Annapolis, Maryland, will pay $3,154,000 to settle allegations that it submitted false claims to Medicare for medically unnecessary evaluation and management services and separately billing bundled procedures
Q: Our utilization review (UR) committee originally took a more strictly peer review role but over time its scope and responsibilities have broadened. We're not sure that it still makes sense for the UR committee to be categorized as a subcommittee of the medical staff. What is the current recommended reporting structure for a UR committee?
The Revenue Integrity Symposium is the only conference I have seen that is packed with sessions that will give revenue integrity professionals practical information that they can take back and institute the next day to help their facility success financially.
CMS may have overpaid hospitals, physicians, and freestanding facilities almost $270 million for polysomnography services that did not meet Medicare requirements over a two-year period, according to an Office of Inspector General report.
On June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.
Put CMS’ proposed changes in perspective to see the bigger picture. Comments are due June 24, so hospitals will need to conduct a careful analysis to determine the impact of the proposed changes and submit specific feedback.
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.
