Compliance & Legal
With Medicare's "two midnight rule" set to take effect later this year and audit appeals facing lengthy backlogs, the Recovery Audit Contractor program may be headed in some new directions.
The House of Representatives passed a bill yesterday to forestall scheduled cuts to Medicare physician payments through April 1, 2015, to delay the ICD-10 implementation deadline for one year, and to suspend enforcement of the controversial two-midnight policy.
It has never been clearer: physician practices must be able to code in ICD-10 to bill for services and procedures after Oct. 1, 2014, or they will see a cash flow interruption, additional costs and delayed claims payments. But payers, clearinghouses and vendors can help you.
In case anyone was wondering, the RACs haven't gone away for good. They're just taking a vacation. The Centers for Medicare & Medicaid Services announced a "pause" in RAC audits last month, in preparation for the procurement of the next round of RAC contracts.
A California health care workers' union is collecting signatures to get two measures onto the ballot that it says would lower health care costs, but hospitals disagree.
There's still plenty of work to do before the Oct. 1 ICD-10 deadline. A recent study found that only 4.8 percent of physician practices reported significant progress in overall ICD-10 readiness. Hospitals report higher levels, but many are still behind.
There's still plenty of work to do before the Oct. 1 ICD-10 deadline. A recent study found that only 4.8 percent of physician practices reported significant progress in overall ICD-10 readiness. Hospitals report higher levels, but many are still behind.
The Obama Administration recovered a record $4.3 billion last year from fraudsters trying to dupe federal health programs, or those who sought payments to which they were not entitled.
With the threat of significant reimbursement losses, hospitals and health systems are feeling the pressure of getting the transition to ICD-10 right.
Conventional wisdom says that too many ICD-10 codes will make it harder for clinicians and medical coders to do their jobs. Some studies suggest a 50 percent or more drop in productivity. But is this an underestimation of the problem?