Randy Wiitala

Healthcare providers may now apply to participate in a new program known as the Bundled Payments for Care Improvement Initiative (shortened to Bundled Payments Initiative [BPI]).

Healthcare providers may now apply to participate in a new program known as the Bundled Payments for Care Improvement Initiative (shortened to Bundled Payments Initiative [BPI]).

The lack of the correct patient discharge status code has been cited by Recovery Audit Contractors (RACs) as a problem in the claims of inpatient rehabilitation facilities (IRFs). The problem is actually twofold; improper use has resulted in overpayments in some cases and underpayments in others.

In the near future, Recovery Audit Contractors and Medicare Administrative Contractors (MACs) will take "appropriate action" on erroneously allowed claims identified in a recently completed audit (OEI-07-09-00450) by OIG.

According to the Centers for Medicare & Medicaid Services, Recovery Auditor Contractors are adjusting claims to align provider payments with Medicare guidelines related to the technical component (TC) of radiology services.

Interest continues to run high on the recently updated signature guidelines issued by the Centers for Medicare & Medicaid Services. One of the new sections in Transmittal 327, issued March 16, relates to additional documentation requests (ADRs) and signature requirements.

Now, “payment-recapture audits” are on their way, thanks to the healthcare reform legislation (officially known as the Patient Protection and Affordable Care Act), which President Obama signed into law on March 10.