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State Medicaid RACs At-A-Glance Section 6411 of the Affordable Care Act of 2010 required States and territories to establish Medicaid Recovery Audit Contractor (RAC) programs. Medicaid RACs are tasked with identifying and recovering Medicaid overpayments and identifying underpayments. As an initial step for establishing their RAC programs, jurisdictions are expected to submit a Medicaid State […]
MLN Matters Number: MM7141 Related Change Request (CR) #: 7141 Related CR Release Date: November 12, 2010 Effective Date: October 1, 2010 Related CR Transmittal #: R807OTN Implementation Date: April 4, 2011 [The following is copied directly from this MLN Matters posting by CMS.] Expansion of Inpatient Prospective Payment System (IPPS) Transfer Policy to Include […]
Action marks first civil money penalty issued by HHS for HIPAA Privacy Rule violations The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) has issued a Notice of Final Determination finding that Cignet Health of Prince George’s County, Md., (Cignet) violated the Privacy Rule of the Health Insurance Portability and […]
Region C List Riddled with Errors Two of the CMS Recovery Audit Contractors (RAC) posted newly approved issues last week to their public websites, as required by CMS before widespread review of those issues can begin. Connolly Healthcare, the RAC for CMS Region C posted 36 new issues on their Approved Issues webpage, on Wednesday, […]
Region C List Riddled with Errors Two of the CMS Recovery Audit Contractors (RAC) posted newly approved issues last week to their public websites, as required by CMS before widespread review of those issues can begin. Connolly Healthcare, the RAC for CMS Region C posted 36 new issues on their Approved Issues webpage, on Wednesday, […]
This document is from: MLN Matters Article #:MM7228 Posted: February 4, 2011 Related CR#: 7228 Effective Date: July 1, 2011 Auto Denial of Claims Submitted With a GZ Modifier The GZ modifier indicates that an Advance Beneficiary Notice (ABN) was not issued to the beneficiary and signifies that the provider expects denial due to a […]
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 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 […]
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 […]
