January, 2011 - Make Your Revenue Smarter

Healthcare Fraud and Abuse Control Program Annual Report

On , in Documents, by AQ-IQ LLC

From the OIG: Fiscal Year 2013 Read the Press Release Fiscal Year 2012 Read the Press Release Fiscal Year 2011 Read the Press Release Read the Fact Sheet Fiscal Year 2010 Fiscal Year 2009 Fiscal Year 2008 Fiscal Year 2007 Fiscal Year 2006 Fiscal Year 2005 Fiscal Year 2004 Fiscal Year 2003 Fiscal Year 2002 […]

Compendium of Unimplemented OIG Recommendations

On , in Documents, by AQ-IQ LLC

Compendium of Unimplemented OIG Recommendations The Compendium consolidates significant unimplemented monetary and nonmonetaryrecommendations addressed to the Department of Health & Human Services (HHS) toprovide information to interested parties about outstanding recommendations that, ifimplemented, have the potential to result in cost savings and improvements to programefficiency and effectiveness. These recommendations resulted from our audits andevaluations that […]

Connolly Posts 77 New Issues, 216 DRGs

On , in Industry News, by AQ-IQ LLC

23 New Issues Approve Medical Necessity Review for 70 DRGs Connolly Healthcare, the Recovery Audit Contractor (RAC) for 17 states posted 77 new issues on their Approved Issues webpage, late in the day on Friday, January 14, 2011. Once again, continuing the pattern that healthcare providers have come to expect from the 4 RACs and […]

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud

On , in Industry News, by AQ-IQ LLC

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud Joint DOJ & HHS  efforts result in largest sum ever recovered in single year; new rules under the Affordable Care Act will keep fraudulent providers and suppliers out of Medicare, Medicaid, CHIP and avoid payments […]

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud

Health care fraud prevention and enforcement efforts recover record $4 billion; new Affordable Care Act tools will help fight fraud Joint DOJ & HHS  efforts result in largest sum ever recovered in single year; new rules under the Affordable Care Act will keep fraudulent providers and suppliers out of Medicare, Medicaid, CHIP and avoid payments […]

Detroit Hospital Settles with DOJ for $30 Million over multiple issues

On , in Industry News, by AQ-IQ LLC

Includes Stark Law issues and self-disclosure of E/M upcoding issues What lawyers call “technical” Stark violations can slam hospitals because of the black-and-white nature of the statute, a fact of life that hit home for Detroit Medical Center, which agreed to pay $30 million to resolve false claims allegations arising from sweetheart deals with referring […]

Detroit Hospital Settles with DOJ for $30 Million over multiple issues

Includes Stark Law issues and self-disclosure of E/M upcoding issues What lawyers call “technical” Stark violations can slam hospitals because of the black-and-white nature of the statute, a fact of life that hit home for Detroit Medical Center, which agreed to pay $30 million to resolve false claims allegations arising from sweetheart deals with referring […]

Revised Instructions for Reporting Assessment Dates under the Inpatient Rehabilitation Facility (IRF), Skilled Nursing Facility (SNF), and Swing Bed (SB) Prospective Payment Systems (PPSs)

On , in Documents, by AQ-IQ LLC

MLN Matters® Number: MM7019 Related Change Request (CR) #: 7019 Related CR Release Date: July 30, 2010 Effective Date: January 1, 2011 Related CR Transmittal #: R2011CP Implementation Date: January 3, 2011   from MLN Matters: Current Medicare instruction requires IRF and SNF PPS providers to report assessment dates in form locator 45, Service Date, […]

State Medicaid Agencies Provider Directory

On , in Documents, by AQ-IQ LLC

A-Z State Medicaid Agencies Provider Directory includes 5 US Territories State Agency Link Alabama Medicaid Agency medicaid.alabama.gov AlaskaMedicaid Health Enterprise medicaidalaska.com American Samoa Government Medicaid americansamoa.gov Arizona Health Care Cost Containment System (AHCCCS) ahcccs.state.az.us Arkansas Medicaid medicaid.state.ar.us California Medical Care Services (Department of Health Services) dhcs.ca.gov Colorado Department of Health Care Policy andFinancing chcpf.state.co.us Connecticut […]