Centers for Medicare and Medicaid Services (“CMS”) reported yesterday that it realizes that fiscal intermediaries haven’t been providing sufficient detail on remittance advices (RAs) when recouping overpayments identified by RACs to allow providers to track and update their financial records. In response to that complaint, CMS issued CR 6870 and the corresponding MLN Matters 6870, […]

In February, we blogged on the recent changes in home health agency (HHA) accreditation. In April 2010, NGS issued its Medicare Monthly Review, and reiterated the same HHA accreditation and change of ownership provisions. Particularly, the article discusses the requirements a deactivated HHA must meet in order to reactivate its billing privileges. It also discusses […]

Meaningful use of electronic health records (EHR) technology has recently been expanded to include physicians providing services in outpatient facilities, according to the Continuing Extension Act of 2010. Initially, Congress had intended that only those physicians who purchased and implemented EHR technology would be eligible for the incentive payments, which would leave hospital-based physicians without […]

The Continuing Extension Act of 2010 was signed into law on April 15. This law reinstates the March 31 Medicare Physician Fee Schedule (Fee Schedule) rates for physicians, postponing, yet again, the anticipated-21.3% cut. The zero percent (0%) update to the Fee Schedule has been extended to May 31 will apply retroactively to claims that […]

Yesterday, the U.S. House of Representatives proposed a bill that ups the ante on Medicare fraud. The bill, the Medicare Fraud Enforcement and Prevention Act, will double prison sentences from 5 to 10 years and fines from $25,000 to $50,000 for Medicare fraud-related crimes, and creates a new crime for illegally distributing patients’ Medicare and […]

The New York state attorney general’s office announced yesterday that it recovered more than $283 million and obtained a record of 148 Medicaid fraud convictions in 2009. This information is detailed in an Annual Report submitted to the Secretary of the U.S. Department of Health and Human Services. The report highlights the cases, settlements, and […]

Pursuant to the healthcare reform bill that was signed into law by President Obama on March 23, 2010 (“the Patient Protection and Affordable Care Act” or “the Act”), physicians who furnish MRI, CT or PET tests within their practices for their patients are now required to provide their patients with a written disclosure at the […]

On Monday, April 6, 2010, CMS updated its RAC website by announcing a series of nationwide calls as detailed below: April 28, 2010, 1:00pm – 2:30pm EST: Nationwide RAC 101 Call, 1-877-251-0301 May 4, 2010, 1:00pm – 2:30pm EST: Nationwide RAC 101 Call for Home Health and Hospice Providers, 1-877-251-0301 May 5, 2010, 1:00pm – […]

The Feds joined a False Claims Act lawsuit against Satilla Regional Medical Center, a Georgia Hospital. The lawsuit, filed by a nurse in 2007, alleges that the hospital allowed an unqualified physician, Najam Azmat, to perform endovascular procedures, leading to the death of at least one patient and injuries to several others. The hospital, which […]

Today, John Muir Health began notifying its 5,450 patients about a possible breach of their personal and health information. The notifications came two months after two laptop computers were stolen from the John Muir Physician Network Perinatal office in Walnut Creek, California. Although the laptops were password protected, and there is no evidence that the […]

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