In Billing
Dec 13th, 2017
In case you were unaware of proper billing of services for Medicare patients in a covered Part A inpatient stay, here is a refresher. Medicare will not pay acute-care hospitals for outpatient services provided to patients in a covered Part A inpatient stay at another facility. This includes Medicare patients who are inpatients of long-term ...
In Audit
Nov 22nd, 2017
The Office of Inspector General (OIG) is recommending Rush University Medical Center, Chicago, Ill., refund $10.2 million in Medicare overpayments based on an audit sample of 120 inpatient and outpatient claims. Rush allegedly did not fully comply with Medicare billing requirements for 57 of the claims, resulting in overpayments of $814,150 for the audit period (2014-2015). The OIG ...
In Audit
Aug 11th, 2011
The Centers for Medicare & Medicaid Services (CMS) issued a final rule this month that increases reimbursement rates paid under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) by 2.2 percent and establishes a new quality reporting system authorized by the Affordable Care Act. CMS projects total payments under the IRF PPS will increase by ...
In CMS
Apr 29th, 2011
The Centers for Medicare & Medicaid Services (CMS) is proposing to update fiscal year 2012 payment policies and rates for hospitals paid under the inpatient, long-term care, and inpatient rehabilitation facilities prospective payment systems (PPS). The two proposed rules with comment periods also would further implement certain Affordable Care Act provisions and several other policy changes. ...
In Billing
Apr 1st, 2011
If Congress takes up recent recommendations made by the Medicare Payment Advisory Commission (MedPAC), acute care and outpatient hospitals, physicians and other health professionals, ambulatory surgical centers (ASCs), end-stage renal dialysis (ESRD) centers, and hospices should see payment rate increases in 2012. But for long-term care hospitals (LTCHs), skilled nursing facilities (SNFs), home hea...