Policy and Legislation
In a recent educational memo (SE1121), the Centers for Medicare & Medicaid Services (CMS) advised hospitals, once again, to improve their Medicare documentation in order to avoid unnecessary claims' denials by the Recovery Audit Contractors.
Although CMS made changes to the billing of concurrent therapy and higher levels of therapy at skilled nursing facilities, Medicare payment rates increased by $2.1 billion between the last six months of 2010 to the first half of 2011, said a report from OIG.
The U.S. Department of Health and Human Services has announced three new initiatives to help states improve the quality and lower the cost of care for "dual eligible" - the approximately nine million Americans who are eligible for both Medicare and Medicaid.
Leonard Langman, MD, a neurologist who owned and operated a Brooklyn, N.Y., medical clinic, pleaded guilty Friday for his role in a scheme to defraud Medicare and several other agencies, according to the Departments of Justice and Health and Human Services.
The Centers for Medicare & Medicaid Services released a report this week showing that 10 states lack sufficient authority under current law to review and reject excessive health insurance rate increases as required under the Affordable Care Act. Beginning Sept. 1 CMS will begin review of all rate hikes in excess of 10 percent for these states.
The University of California at Los Angeles Health System (UCLAHS) is settling potential violations of the Health Insurance Portability and Accountability Act’s (HIPAA) Privacy and Security Rules for $865,500 said the U.S. Department of Health and Human Services' Office for Civil Rights.
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.
Physicians working under contract with the federal government practice less defensive medicine than their private sector peers, according to a new survey by Atlanta-based clinical staffing organization, Jackson Healthcare.
Over the last week, the Centers for Medicare & Medicaid Services (CMS) has issued proposed changes that will update payment policies and rates for physicians, dialysis facilities and for services to Medicare beneficiaries in hospital outpatient departments and decrease Medicare payments to home health agencies.
In its June Health Tracking Poll, Kaiser Family Foundation found that Americans generally do not have confidence in Congress or private insurers to keep Medicare financially sound.