Compliance & Legal
Providers and patient advocates are deeply worried about a case that they say could restrict their ability across the country to seek judicial relief from low Medicaid reimbursement rates.
Lawyers for Seattle Children's Hospital and Texas Children's Hospital convinced a federal judge to temporarily block the enforcement of a Medicaid rule requiring private insurance reimbursement to be included in calculating their hospital-specific limits to these payments.
The Centers for Medicare and Medicare Services has extended the contract with four private companies it previously hired to track down, remedy and often recover improper Medicare payments.
The Affordable Care Act is on the move in Western states, with the governors of Utah, Wyoming and Montana all working to hammer out deals with the Obama administration to expand Medicaid in ways tailored to each state.
Extending the ICD-10 transition another 12 months has been significant -- estimated in the millions.
Revenue cycle management firm Accretive Health restated its 2013 results last week, showing that the company swung to a $130 million profit for the year, compared to a loss of nearly $120 million in 2012.
This week the HHS Office of Inspector General (OIG) published its annual solicitation of recommendations for new or modified safe harbor provisions under the federal anti-kickback statute, as well as potential topics for new OIG Special Fraud Alerts.
When Healthcare Finance last year asked experts to name the top industry trends, they selected insurance exchanges, mergers and acquisitions, new payment models, and technology. Things don't look much different in 2015.
ICD-10 testing will be a valuable step in the ICD-10 transition but it will be more complicated than sending medical claims to healthcare payers and asking, "How's that?"
Between online marketplaces for Social Security numbers and data hijackings at Sony and critical access hospitals, catching and preventing fraud has never been more important or dependent on technology.