From the OIG News Release: The newest step in OIG’s Provider Compliance Training initiative is free videos and audio podcasts – averaging about four minutes each – which cover major health care fraud and abuse laws, the basics of health care compliance programs, and what to do when a compliance issue arises. The first […]
This document includes links to CMS details regarding the RAC Program. Recovery Audit Program Home Page Medicare FFS RAC contact info (12.6.16) [PDF, 223KB] Medicare FFS RAC Map – November 2016 [PDF, 244KB] Nov. 30, 2016 RAC SOW Regions 1-4 [PDF, 517KB] Nov. 30, 2016 RAC SOW Region 5 [PDF, 1MB] Medicare Learning Network Provider […]
The Diagnosis Related Groups (DRGs), Service Intensity Weights (SIWs), Trimpoints and Average Length of Stays (ALOS) are used by the Medicaid Program to make DRG payments to New York State Hospitals. They are also published in 10NYCRR Part 86-1.62 and 86-1.63 and updated as necessary. Any questions regarding the DRGs, SIWs, Trimpoints or Average Length […]
Each year, the Medicare Fee-For-Service (FFS) Program makes billions of dollars in estimated improper payments. CMS employs several types of Review Contractors to measure, prevent, identify, and correct these improper payments. For more information about Medicare improper payments, go to www.paymentaccuracy.gov Review Contractors find the improper payments by selecting a small sample of claims, requesting […]
Visit this page at CMS.gov for updates and additional details. Effective immediately, the point of contact (POC) for all questions or concerns related to New Posting Notifications is Alpheus Parkes. Please feel free to contact me by phone (410-786-0282) or e-mail (alpheus.parkes@cms.hhs.gov.). Thank you. Section 302 of the Tax Relief and Health Care Act of […]
This document is from: MLN Matters Article #:SE1037 Guidance on Hospital Inpatient Admission Decisions It is important that any staff involved with the clinical decision to admit the patientstay abreast of all CMS national inpatient hospital policy and National and Local Coverage Determinations. Additionally, make sure medical documentation submitted demonstrates evidence of the clinical need […]
Modifier -33: “Preventive Services”: When the primary purpose of the service is the delivery of an evidence-based service in accordance with a US Preventive Services Task Force A or B rating in effect and other preventive services identified in preventive services mandates (legislative or regulatory), the service may be identified by appending modifier 33, Preventive […]
CMS has developed attestation worksheets to help providers successfully attest to meeting meaningful use through the CMS web-based attestation system. These attestation worksheets allow eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) to log additional data for core and menu measures that might not be obtained only through their certified electronic health record […]
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, […]