When it comes to using offshore resources, there are several important compliance requirements HIM professionals need to know. These requirements were created by CMS a decade ago and apply to the use of offshore contractors for all Medicaid, Medicare, and TRICARE patients.
In several recent reports, the Office of Inspector General (OIG) determined that providers are, on average, variant from expected volumes on both short stay inpatient and long stay observation cases. What was not made clear in the OIG report is the reason why it believes such variances exist. The answer to this question likely rests within the details of how hospitals have adjusted (or not adjusted) to the use and application of “new criteria” in their daily and ongoing Medicare billing compliance processes.
This week’s Medicare updates include a revision to State Operations Manual Appendix PP; ICD-10 Coding Revisions to NCDs, clarification of payment policy changes for Negative Pressure Wound Therapy using a disposable device and the outlier payment methodology for home health services; and more!
This week’s Medicare updates include the delay of the effective date of the Advancing Care Coordination Through Episode Payment Models; Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model; a quarterly update to the Medicare Physician Fee Schedule database; ICD-10 coding revisions to National Coverage Determinations; and more!
This week’s Medicare updates include Advance Care Planning implementation for OPPS claims, revision to State Operations Manual Appendix PP - incorporating revised Requirements of Participation for Medicare and Medicaid certified nursing facilities, and more!
This week’s Medicare updates include Medicare Outpatient Observation Notice (MOON) instructions, ICD-10 coding revisions to NCDs, a new “K” code for continuous positive airway pressure device bundle, and more!
The Office for Civil Rights (OCR) released guidance on patient access fees with little fanfare last year but the guidance, intended to clarify existing OCR regulations, became a flashpoint for controversy. The guidance states that organizations may charge a patient either a flat fee of $6.50 or follow a specific methodology for calculating the cost of making a copy of requested patient records. Although some organizations found their fee schedules out of step with OCR’s guidance, the biggest problem came from an unexpected corner: attorneys.
This week’s Medicare updates include additional guidance on the MOON form, an NCA for leadless pacemakers, delayed implementation of the (ESRD) Interim Final Rule – Third Party Payment, and more!
This week’s Medicare updates include the latest Medicare Quarterly Provider Compliance Newsletter, a proposed decision memorandum for hyperbaric oxygen therapy NCA, new interest rates for Medicare overpayments and underpayments for Q2 2017, and more!
