Compliance & Legal
About six years ago, Anne Peters, MD, an internist practicing in southern California, started receiving calls from doctors in her area. They told her their patients were reporting that she was billing Medicare for procedures she had done for them – things like brain scans and surgery – procedures she didn’t do.
Citing a CMS survey that found one quarter of providers do not believe they will be ready by October 1, 2013, HHS argues for delaying ICD-10 implementation by one year.
The Office of Inspector General (OIG) has been cracking down recently on Medicare overpayments to hospitals.
Cost overruns on healthcare construction projects can mean big bucks to hospital executives overseeing capital spending. Staying on budget takes a watchful eye and guiding hand at the C-suite level and a deep enough understanding of the design and construction processes to create the proper budget from the start, say industry experts.
A remote monitoring program implemented by Geisinger Health Plan using interactive voice response (IVR) and other telemonitoring technology to aid case managers has shown a 44 percent reduction in hospital readmissions, the company announced recently.
Tom Sullivan examines the possibility of an ICD-10 delay causing the U.S. to move directly to ICD-11.
Roy Snell, CEO of the Heath Care Compliance Association and the Society of Corporate Compliance and Ethics spoke recently with Healthcare Finance News Editor René Letourneau about compliance trends in 2012.
The American Medical Association (AMA) urges HHS to put the breaks on ICD-10, while the American Health Information Management Association (AHIMA) wants to stay the course.
Hospital audits conducted through the Centers for Medicare & Medicaid Services' Recovery Audit Contractor (RAC) program are usually handled by compliance departments and are generally managed by a single full-time employee (FTE), according to a new survey from the Health Care Compliance Association (HCCA).
The U. S. Department of Health and Human Services announced Thursday that an independent review of proposed health insurance rate increases by Trustmark Life Insurance Company affecting members in five states are "unreasonable."