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Indeterminate Descriptions Could Include Over 200 MS-DRGs Connolly Healthcare, the Recovery Audit Contractor (RAC) for 17 states posted 35 new issues on their Approved Issues webpage and removed 4 older issues, mid-day on Wednesday, November 17, 2010. The postings continue the pattern that healthcare providers have come to expect from the 4 RACs and their […]
“Permissive” Exclusions, Even on Managers, Not Subject to Review The Office of the Inspector General (OIG) issued guidance recently, via public statements, documents and actions, explaining that it fully intends to use permissive exclusions under Sec. 1128(b)(15) of the Social Security Act, to prevent owners, officers and managing employees from working in, for or with […]
Below are direct links to the OIG site. Click on the links to see an Executive Summary of each report, with a download link below the summary text. FY2011 09-29-2011 Verification of Saint Francis Medical Center’s Refund of Place-of-Service Overpayments for Calendar Years 2009 Through 2010 (A-01-11-00512) 09-26-2011 Medicare Compliance Review of Baystate Medical Center […]
Deadline may not be extended, as before The FTC “Red Flags Rule” requires a broad range of companies to install identity theft protection programs by December 31, 2010. Red Flags are warning signals to alert a business to potential identity theft. Previously, the deadlines have been extended by the FTC, due to the volume of […]
The Red Flags Rule [PDF] The Red Flags Rule: Frequently Asked Questions The Red Flags Rule requires many businesses and organizations to implement a written Identity Theft Prevention Program to detect the warning signs — or “red flags” — of identity theft in their day-to-day operations. The staff of the Federal Trade Commission (FTC) has […]
Congress expected to intervene, as before “Without congressional action, physician payments will be slashed 25% with the first cut of 23% beginning Dec. 1,” Cecil Wilson, president of the American Medical Association, said in a prepared statement. CMS issued a final rule on Nov. 3, and announced that payment rates were scheduled to be reduced […]
CMS announces education effort to support program The Centers for Medicare & Medicaid Services (CMS) today [Friday, November 5, 2010] proposed new rules to help states reduce improper payments for Medicaid health care claims through the use of Medicaid Recovery Audit Contractors (RACs) as part of the Affordable Care Act’s larger strategy to crack down […]
Congress expected to intervene, as before “Without congressional action, physician payments will be slashed 25% with the first cut of 23% beginning Dec. 1,” Cecil Wilson, president of the American Medical Association, said in a prepared statement. CMS issued a final rule on Nov. 3, and announced that payment rates were scheduled to be reduced […]
CMS announces education effort to support program The Centers for Medicare & Medicaid Services (CMS) today [Friday, November 5, 2010] proposed new rules to help states reduce improper payments for Medicaid health care claims through the use of Medicaid Recovery Audit Contractors (RACs) as part of the Affordable Care Act’s larger strategy to crack down […]
