March, 2011 - Make Your Revenue Smarter

Medicare Shared Savings Program

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The U.S. Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other health care providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).  ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, […]

Get Involved to Improve Healthcare

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CMS Launches Site for New Approach to Healthcare This week, the Center for Medicare and Medicaid Innovation (“Innovation Center”) re-launched Innovations.cms.gov. Along with providing information about the Innovation Center’s mission and values, the website provides ways for the Innovation Center to gather new ideas to improve our health care system. The Innovations website also encourages […]

Get Involved to Improve Healthcare

CMS Launches Site for New Approach to Healthcare This week, the Center for Medicare and Medicaid Innovation (“Innovation Center”) re-launched Innovations.cms.gov. Along with providing information about the Innovation Center’s mission and values, the website provides ways for the Innovation Center to gather new ideas to improve our health care system. The Innovations website also encourages […]

Connolly Posts New RAC Issue, 309 DRG Validations, 141 ICD-9 Codes

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Includes 29 MS-DRGs for Medical Necessity Review Connolly Healthcare posted a new approved issue calling for DRG Validation review of 309 MS-DRGs and/or 141 ICD-9 diagnosis codes, on Thursday evening, March 17, 2011. Connolly is the CMS Recovery Audit Contractor for Region C, responsible for audits of healthcare providers who bill Medicare in 17 states […]

MEDPAC Report to Congress March, 2011

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From the Report Introduction: The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 (P.L. 105–33) to advise the U.S. Congress on issues affecting the Medicare program. Two reports—issued in March and June each year—are the primary outlets for Commission recommendations. This report contains 13 chapters: […]

Medicare Payment Advisory Commission Report to Congress March, 2011

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From the Report Introduction: Medicare Payment Advisory Commission’s March 2011 Report to the Congress fulfills the MEDPAC Commission’s legislative mandate to evaluate Medicare payment issues and to make recommendations to the Congress. The report contains 13 chapters: • context for those that follow by documenting the rise in Medicare and total health care spending. • […]

MEDPAC Report to Congress March, 2011

From the Report Introduction: The Medicare Payment Advisory Commission (MedPAC) is an independent congressional agency established by the Balanced Budget Act of 1997 (P.L. 105–33) to advise the U.S. Congress on issues affecting the Medicare program. Two reports—issued in March and June each year—are the primary outlets for Commission recommendations. This report contains 13 chapters: […]

Protected: Spooner Health System Private Page

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Georgia Pediatrician Sentenced

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Thomaston Pediatrician Pleads Guilty to Medicaid Fraud Kathy Mansfield, a Thomaston pediatrician and owner of Pediatric Associates of Thomaston, Inc., pled guilty yesterday to one count of Medicaid Fraud for intentionally overbilling the Medicaid Program in the amount of approximately $537,428. From 2003 to 2007, Mansfield billed Medicaid for the Synagis, a drug used to prevent […]