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.
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.
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.
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.
The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.
Federal fraud watchdog agencies may be taking a closer look at Medicare Advantage in 2019, according to a recent report released by Bass, Barry & Sims, a Washington, D.C.-based law firm.
Q: How far in advance are we required to provide an Advance Beneficiary Notice of Noncoverage (ABN)? If multiple entities are involved in ordering and providing a noncovered service such as a lab test, does each entity need to issue a separate ABN?
The Office of Inspector General (OIG) will be taking a closer look at payments for inpatient claims subject to CMS’ post-acute transfer policy, according to a recent update to the OIG work plan.
The National Association of Healthcare Revenue Integrity is currently seeking speakers to present at the 2019 Revenue Integrity Symposium (RIS), to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida.
CMS ramped up risk-sharing for accountable care organizations (ACO) in a final rule published December 31, 2018. The final rule makes changes to the Medicare Shared Savings Program and will reduce the amount of time ACOs can stay in one-sided risk models.
