In Audit
Aug 15th, 2017
Effective June 15, 2017, the Office of Inspector General (OIG) now updates its Work Plan website monthly. The OIG Work Plan sets forth various projects — including OIG audits and evaluations that are underway or planned — to be addressed during the fiscal year and beyond by OIG’s Office of Audit Services and Office of ...
In CMS
Aug 10th, 2017
The Office of Inspector General (OIG) says noncompliance of the three-day rule continues to cost Medicare millions of dollars, every year. In 2013-14, National Government Services (NGS), alone, reportedly overpaid New England providers an estimated $1.3 million. This estimate is based on a stratified random sample of 129 nonphysician outpatient services furnished within three days ...
In Audit
Aug 1st, 2017
Effective June 23, the Centers for Medicare & Medicaid Services (CMS) changed its locum tenens policy, and expanded it to include physical therapists. Section 1842(b)(6)(D) of the Social Security Act allows payment for physician services provided by a physician other than the patient’s physician when the patient’s physician is unavailable. The policy covers both informal ...
In Audit
Jul 13th, 2017
Think your healthcare covered entity doesn’t need to establish and maintain Business Associate Agreements (BAA) with companies who can access your patients’ protected health information (PHI)? Think again. Cases in Point March 2016 — North Memorial Health Care agreed to pay the U.S. Department of Health and Human Services (HHS) $1,550,000 to settle charges that it potentially ...
Jul 6th, 2017
Charlotte-Mecklenburg Hospital Authority is paying the federal government $6.5 million to resolve allegations the company violated the False Claims Act, up-coding claims for urine drug tests. The group, owned by Carolina HealthCare System, submitted high complexity evaluation and management (E/M) codes for urine drug tests, which Medicare considers moderate complexity. The government alleged that t...