Medicare Compliance & Reimbursement
Medicare Reform:
CONGRESS PASSES MAJOR MEDICARE REFORM BILL
Revamp features Rx benefit, increased managed care presence and much, much more funding.Co... Read more
CONGRESS PASSES MAJOR MEDICARE REFORM BILL
Revamp features Rx benefit, increased managed care presence and much, much more funding.Co... Read more
Health Plans:
THE WINNERS: HEALTH PLANS POISED TO RE-ENTER MEDICARE
Health plans are the clear victors in the new landmark legislation.Health plans won a majo... Read more
THE WINNERS: HEALTH PLANS POISED TO RE-ENTER MEDICARE
Health plans are the clear victors in the new landmark legislation.Health plans won a majo... Read more
Reimbursement:
THE WINNERS: MONEY THROWN AT HOSPITALS, DOCS, EMPLOYERS
Increased reimbursement will help hospital and physicians. One of the stories in the Medic... Read more
THE WINNERS: MONEY THROWN AT HOSPITALS, DOCS, EMPLOYERS
Increased reimbursement will help hospital and physicians. One of the stories in the Medic... Read more
DME:
THE LOSERS: DME INDUSTRY HEADED FOR A MELTDOWN
Compromise over Medicare legislation harsh on suppliers.All suppliers' worst nightmares ha... Read more
THE LOSERS: DME INDUSTRY HEADED FOR A MELTDOWN
Compromise over Medicare legislation harsh on suppliers.All suppliers' worst nightmares ha... Read more
Home Health:
THE LOSERS: HHAs HURTING DESPITE COPAY VICTORY
Rural add-on falls short of hopes.Home health agencies may have celebrated their political... Read more
THE LOSERS: HHAs HURTING DESPITE COPAY VICTORY
Rural add-on falls short of hopes.Home health agencies may have celebrated their political... Read more
Rx Drugs:
THE DETAILS: THE DETAILS:
The in's and out's of the complicated new addition to Medicare. With so much discuss... Read more
THE DETAILS: THE DETAILS:
The in's and out's of the complicated new addition to Medicare. With so much discuss... Read more
Pharmaceuticals:
MEDICARE BILL RETAINS REIMPORATION RESTRICTIONS
The movement to import less-expensive, Food and Drug Administration-approved medications f... Read more
MEDICARE BILL RETAINS REIMPORATION RESTRICTIONS
The movement to import less-expensive, Food and Drug Administration-approved medications f... Read more
BILL WATCH
Bills introduced in the House: HR 3535. A bill to amend title XVIII of the Social Securit... Read more
Bills introduced in the House: HR 3535. A bill to amend title XVIII of the Social Securit... Read more
Medicare Reform:
FRIST, HASTERT PROPOSE, PREMIUM SUPPORT COMPROMISE
Senate Majority Leader Bill Frist (R-TN) and House Speaker Dennis Hastert (R-IL) shook up ... Read more
FRIST, HASTERT PROPOSE, PREMIUM SUPPORT COMPROMISE
Senate Majority Leader Bill Frist (R-TN) and House Speaker Dennis Hastert (R-IL) shook up ... Read more
Rehab:
REHAB PROVIDERS RALLY AGAINST 75 PERCENT RULE
The City of Brotherly Love is showing no love for the proposed "fix" to the 75 percent rul... Read more
REHAB PROVIDERS RALLY AGAINST 75 PERCENT RULE
The City of Brotherly Love is showing no love for the proposed "fix" to the 75 percent rul... Read more
Reimbursement:
GOOD NEWS FOR HOSPITALS, BAD NEWS FOR REHAB
Hospitals will get an average 4.5 percent reimbursement increase for outpatient services u... Read more
GOOD NEWS FOR HOSPITALS, BAD NEWS FOR REHAB
Hospitals will get an average 4.5 percent reimbursement increase for outpatient services u... Read more
DME:
Supplier Number Process Sputters Back To Life
A select few will begin receiving their supplier number soon. "Don't call us, we'll ... Read more
Supplier Number Process Sputters Back To Life
A select few will begin receiving their supplier number soon. "Don't call us, we'll ... Read more
EMTALA:
8 THINGS HOSPITALS NEED TO KNOW ABOUT THE NEW EMTALA GUIDANCE
Don't get caught off guard by state surveyors or the OIG. Are you up to speed with t... Read more
8 THINGS HOSPITALS NEED TO KNOW ABOUT THE NEW EMTALA GUIDANCE
Don't get caught off guard by state surveyors or the OIG. Are you up to speed with t... Read more
Medicare Appeals:
CMS RULE CREATES NEW APPEAL TOOL
A final rule published in the Nov. 7 Federal Register rounds out the arsenal available to ... Read more
CMS RULE CREATES NEW APPEAL TOOL
A final rule published in the Nov. 7 Federal Register rounds out the arsenal available to ... Read more
HIPAA:
KEEP DIRECTORIES IN LINE WITH HIPAA RULES
OCR clarifies the impact of HIPAA privacy rules on patient directories. Hospitals go... Read more
KEEP DIRECTORIES IN LINE WITH HIPAA RULES
OCR clarifies the impact of HIPAA privacy rules on patient directories. Hospitals go... Read more
Enforcement:
FRAUD-FIGHTERS TOUT RECORD-BREAKING YEAR
Allowing your commitment to compliance to waver could cost you big. Think the campai... Read more
FRAUD-FIGHTERS TOUT RECORD-BREAKING YEAR
Allowing your commitment to compliance to waver could cost you big. Think the campai... Read more
ESRD:
DIALYSIS FACILITIES UNDER THE GUN
Dialysis facilities who run into trouble on surveys will face much harsher penalties than ... Read more
DIALYSIS FACILITIES UNDER THE GUN
Dialysis facilities who run into trouble on surveys will face much harsher penalties than ... Read more
BILL WATCH
Bills introduced in the House: HR 3458. A bill to amend titles XVIII and XIX of the Social... Read more
Bills introduced in the House: HR 3458. A bill to amend titles XVIII and XIX of the Social... Read more
CMS MANUAL UPDATE
The annual update to local clinical laboratory fees will be 2.6 percent in 2004, the Cente... Read more
The annual update to local clinical laboratory fees will be 2.6 percent in 2004, the Cente... Read more
Home Health:
Home Health Outcomes Debut On Web, In Newspapers
HHAs grappling with new publicity.Chances are more people than ever are thinking abou... Read more
Home Health Outcomes Debut On Web, In Newspapers
HHAs grappling with new publicity.Chances are more people than ever are thinking abou... Read more
Hospitals:
HOSPITALS SLATED FOR 4.5 PERCENT PAY BOOST
Pass through payments escape across-the-board cuts. Hospitals will collect 4.5 perc... Read more
HOSPITALS SLATED FOR 4.5 PERCENT PAY BOOST
Pass through payments escape across-the-board cuts. Hospitals will collect 4.5 perc... Read more
Physicians:
PHYSICIANS GET A BREAK ON APPEALS DOCUMENTATION
Long-delayed coverage appeal rule at last in final form. Burdensome physician certi... Read more
PHYSICIANS GET A BREAK ON APPEALS DOCUMENTATION
Long-delayed coverage appeal rule at last in final form. Burdensome physician certi... Read more
Medicare Reform:
MANY ISSUES STILL UNRESOLVED WITH TIME RUNNING OUT
Final bill looking increasingly unlikely. Congressional Medicare negotiators are not... Read more
MANY ISSUES STILL UNRESOLVED WITH TIME RUNNING OUT
Final bill looking increasingly unlikely. Congressional Medicare negotiators are not... Read more
Rehab:
OIG TAKING A CLOSER LOOK AT REHAB
Medical necessity and cardiac rehab top the OIG's list of hot spots. The 2004 Work P... Read more
OIG TAKING A CLOSER LOOK AT REHAB
Medical necessity and cardiac rehab top the OIG's list of hot spots. The 2004 Work P... Read more
Labs:
WHAT LAB SURVEYORS ARE LOOKING FOR, PART 2
CLIA inspectors offer insider tips for a smoother recovery. This is the continuation... Read more
WHAT LAB SURVEYORS ARE LOOKING FOR, PART 2
CLIA inspectors offer insider tips for a smoother recovery. This is the continuation... Read more
Home Health:
OASIS COLLECTION SUSPENDED FOR PRIVATE-PAY PATIENTS
Burdensome home health requirement lifted - at least for now.In a surprise move, Medicare ... Read more
OASIS COLLECTION SUSPENDED FOR PRIVATE-PAY PATIENTS
Burdensome home health requirement lifted - at least for now.In a surprise move, Medicare ... Read more
Medicare+Choice:
MEDICARE LOOKING TO PPOs, PPOs LOOKING FOR FUNDING
Early-adopting Medicare PPOs site some success, but many questions. If preferre... Read more
MEDICARE LOOKING TO PPOs, PPOs LOOKING FOR FUNDING
Early-adopting Medicare PPOs site some success, but many questions. If preferre... Read more
HIPAA:
LAWYERS SEEK CLARITY ON HIPAA PRIVACY RULE
How far do your attorney's obligations go?Will the Health Insurance Portability and Accoun... Read more
LAWYERS SEEK CLARITY ON HIPAA PRIVACY RULE
How far do your attorney's obligations go?Will the Health Insurance Portability and Accoun... Read more
Compliance:
SENATORS RALLY FOR NEW IG
Health care fraud enforcement top spot needs a body. Two top dogs in the Senate Fina... Read more
SENATORS RALLY FOR NEW IG
Health care fraud enforcement top spot needs a body. Two top dogs in the Senate Fina... Read more
CMS MANUAL UPDATE
Physicians billing for lung volume reduction surgery - which will be covered by Medicare s... Read more
Physicians billing for lung volume reduction surgery - which will be covered by Medicare s... Read more
Rehab:
PROVIDERS GRAPPLING WITH INCOMING RULE
Rule could put some IRFs out of business. Now that the comment period has ended... Read more
PROVIDERS GRAPPLING WITH INCOMING RULE
Rule could put some IRFs out of business. Now that the comment period has ended... Read more
Physicians:
CMS ANNOUNCES RATE CUT, BUT CONGRESS MAY REVERSE
Physicians are slated to receive a 4.5 percent cut in Medicare reimbursement under a fina... Read more
CMS ANNOUNCES RATE CUT, BUT CONGRESS MAY REVERSE
Physicians are slated to receive a 4.5 percent cut in Medicare reimbursement under a fina... Read more
Home Health:
HHAs Preparing For M0175 Recoupments This Spring
Millions of dollars in takebacks based on patient hospital stays are on agencies' horizons... Read more
HHAs Preparing For M0175 Recoupments This Spring
Millions of dollars in takebacks based on patient hospital stays are on agencies' horizons... Read more
Long-Term Care:
THREE-DAY HOSPITAL-STAY RULE STILL VEXES OIG
Nursing homes could face overpayment demands. Are skilled nursing facilities across ... Read more
THREE-DAY HOSPITAL-STAY RULE STILL VEXES OIG
Nursing homes could face overpayment demands. Are skilled nursing facilities across ... Read more
Labs:
WHAT LAB SURVEYORS ARE LOOKING FOR
CLIA inspectors offer insider tips for a smoother survey. Laboratory inspectors aro... Read more
WHAT LAB SURVEYORS ARE LOOKING FOR
CLIA inspectors offer insider tips for a smoother survey. Laboratory inspectors aro... Read more
Pharmaceuticals:
CMS REVS UP STATES ON MEDICARE DRUG DISCOUNT CARDS
Program will go live next spring. Even though legislation establishing a Medicare-en... Read more
CMS REVS UP STATES ON MEDICARE DRUG DISCOUNT CARDS
Program will go live next spring. Even though legislation establishing a Medicare-en... Read more
Home Health:
Bidding In, Copays Out In Latest Medicare Legislation
Home care provisions in flux.Congressional leaders are stepping up the intensity of Medica... Read more
Bidding In, Copays Out In Latest Medicare Legislation
Home care provisions in flux.Congressional leaders are stepping up the intensity of Medica... Read more
Pharmaceuticals:
ASSAULT CONTINUES ON DRUGMAKER RECORDKEEPING RULE
States call on CMS to withdraw controversial pharma reg. Drugmakers will have t... Read more
ASSAULT CONTINUES ON DRUGMAKER RECORDKEEPING RULE
States call on CMS to withdraw controversial pharma reg. Drugmakers will have t... Read more
Rehab:
CAPS COULD SPAWN NEW ERA IN HOSPITAL-SNF RELATIONSHIPS
As long as the therapy caps are in place, many patients will be shuffled to outpatient set... Read more
CAPS COULD SPAWN NEW ERA IN HOSPITAL-SNF RELATIONSHIPS
As long as the therapy caps are in place, many patients will be shuffled to outpatient set... Read more
Medicaid:
TX PROVIDERS MAY FACE IMD RECOUPMENTS
Ongoing OIG probe addresses Medicaid payments for IMD residents.In its latest attempt to a... Read more
TX PROVIDERS MAY FACE IMD RECOUPMENTS
Ongoing OIG probe addresses Medicaid payments for IMD residents.In its latest attempt to a... Read more
BILL WATCH
The following bill was introduced in the House: HR 3382. A bill to amend titles II and XV... Read more
The following bill was introduced in the House: HR 3382. A bill to amend titles II and XV... Read more
Medicare Reform:
LEGISLATORS STILL DISAGREE ON ROLE OF PRIVATE PLANS
Past the initial deadline for a final bill, experts say process could go until Decemb... Read more
LEGISLATORS STILL DISAGREE ON ROLE OF PRIVATE PLANS
Past the initial deadline for a final bill, experts say process could go until Decemb... Read more
Hospitals:
TURF BATTLE OVER SPECIALTY HOSPITALS CONTINUES
GAO weighs in on the debate. The growing popularity of specialty hospitals has gener... Read more
TURF BATTLE OVER SPECIALTY HOSPITALS CONTINUES
GAO weighs in on the debate. The growing popularity of specialty hospitals has gener... Read more
Home Health:
COPAY THREAT PERSISTS AS HOME CARE INDUSTRY STRIKES BACK
Medicare home care funding is more vulnerable to cuts than ever as negotiations continue o... Read more
COPAY THREAT PERSISTS AS HOME CARE INDUSTRY STRIKES BACK
Medicare home care funding is more vulnerable to cuts than ever as negotiations continue o... Read more
Labs:
CLIA SURVEYORS AWAIT GREEN LIGHT FROM FEDS
Find out how surveyors intend to handle deficiencies in the meantime. CLIA inspector... Read more
CLIA SURVEYORS AWAIT GREEN LIGHT FROM FEDS
Find out how surveyors intend to handle deficiencies in the meantime. CLIA inspector... Read more
Long-Term Care:
SENIORS' HOME EQUITY EYED AS KEY TO PAYING LTC BILLS
Well-off seniors benefitting from Medicaid while state budgets languish, Scully says. ... Read more
SENIORS' HOME EQUITY EYED AS KEY TO PAYING LTC BILLS
Well-off seniors benefitting from Medicaid while state budgets languish, Scully says. ... Read more
Rehab:
REHAB PROVIDERS LAUNCH NEW SALVO AGAINST 75-PERCENT RULE
IRFs will shut down unless CMS acts, rehab hospitals argue. Inpatient rehabilitation... Read more
REHAB PROVIDERS LAUNCH NEW SALVO AGAINST 75-PERCENT RULE
IRFs will shut down unless CMS acts, rehab hospitals argue. Inpatient rehabilitation... Read more
Business Arrangements:
OIG SHINES LIGHT ON ADVISORY OPINIONS
What to expect if you want an OIG stamp of approval on your business needs. ... Read more
OIG SHINES LIGHT ON ADVISORY OPINIONS
What to expect if you want an OIG stamp of approval on your business needs. ... Read more
Pharmaceuticals:
DRUGMAKER RECORDKEEPING RULE SPARKS GRASSLEY'S IRE
False Claims Act architect says Medicaid rebate rule will foil whistleblowers. Drugmakers ... Read more
DRUGMAKER RECORDKEEPING RULE SPARKS GRASSLEY'S IRE
False Claims Act architect says Medicaid rebate rule will foil whistleblowers. Drugmakers ... Read more
Medicaid:
CMS TO HIRE 100 MEDICAID-MAXIMIZATION COPS
The White House Office of Management and Budget has approved hiring 100 new federal employ... Read more
CMS TO HIRE 100 MEDICAID-MAXIMIZATION COPS
The White House Office of Management and Budget has approved hiring 100 new federal employ... Read more
Hospitals:
IS MANDATORY QUALITY REPORTING ON THE HORIZON FOR HOSPITALS?
CMS chief Tom Scully isn't happy about early results on voluntary reporting. Last D... Read more
IS MANDATORY QUALITY REPORTING ON THE HORIZON FOR HOSPITALS?
CMS chief Tom Scully isn't happy about early results on voluntary reporting. Last D... Read more
EMTALA:
IMPROPER PSYCH TRANSFERS PROMPT INVESTIGATION
ED docs fired as health department probes EMTALA problems. The Emergency Medical Tre... Read more
IMPROPER PSYCH TRANSFERS PROMPT INVESTIGATION
ED docs fired as health department probes EMTALA problems. The Emergency Medical Tre... Read more
BILL WATCH
Bills introduced in the House: HR 3299. A bill to provide for prescription drugs at reduc... Read more
Bills introduced in the House: HR 3299. A bill to provide for prescription drugs at reduc... Read more
MANUAL UPDATE ROUNDUP
A common working file edit flagging too many immunosuppressive drug claims should soon get... Read more
A common working file edit flagging too many immunosuppressive drug claims should soon get... Read more
Medicare Reform:
GOP LEADERS' MEDICARE DEADLINE PASSES SANS DEAL
To no one's surprise, House and Senate negotiators failed to produce compromise legislatio... Read more
GOP LEADERS' MEDICARE DEADLINE PASSES SANS DEAL
To no one's surprise, House and Senate negotiators failed to produce compromise legislatio... Read more
DME:
SUPPLIER-NUMBER FREEZE DEVASTATES DME PROVIDERS
Earliest issuances slated for Nov. 1, for lucky few. Durable medical equipment supp... Read more
SUPPLIER-NUMBER FREEZE DEVASTATES DME PROVIDERS
Earliest issuances slated for Nov. 1, for lucky few. Durable medical equipment supp... Read more
HIPAA:
7 KEY STEPS FOR HIPAA CONTINGENCY PLANNING
CMS tips its hand as to what it expects from providers who aren't ready for the HIPAA tran... Read more
7 KEY STEPS FOR HIPAA CONTINGENCY PLANNING
CMS tips its hand as to what it expects from providers who aren't ready for the HIPAA tran... Read more
Compliance:
COMPLIANCE FUNDAMENTALS COULD BE IN FOR A SHIFT
"Widespread" corporate misconduct sparks a new look at compliance programs. What the... Read more
COMPLIANCE FUNDAMENTALS COULD BE IN FOR A SHIFT
"Widespread" corporate misconduct sparks a new look at compliance programs. What the... Read more
Coverage:
CMS SETS ITSELF DEADLINES FOR COVERAGE DETERMINATION
Beginning Oct. 27, Medicare national coverage determinations will follow newly defined tra... Read more
CMS SETS ITSELF DEADLINES FOR COVERAGE DETERMINATION
Beginning Oct. 27, Medicare national coverage determinations will follow newly defined tra... Read more
Coverage:
DON'T COUNT ON COVERAGE FOR ACUPUNCTURE
CMS nixes requests to cover acupuncture for osteoarthritis, fibromayalgia. Health ca... Read more
DON'T COUNT ON COVERAGE FOR ACUPUNCTURE
CMS nixes requests to cover acupuncture for osteoarthritis, fibromayalgia. Health ca... Read more
Premiums:
MEDICARE PREMIUMSUP AGAIN IN 2004
Elderly paitents will be paying more for their Medicare coverage. Once again, the De... Read more
MEDICARE PREMIUMSUP AGAIN IN 2004
Elderly paitents will be paying more for their Medicare coverage. Once again, the De... Read more
Medicare PPO Demo:
PPO DEMO MOSTLY SERVES SAME AREAS AS M+C HMOs
With congressional negotiators debating how to involve more preferred provider organizatio... Read more
PPO DEMO MOSTLY SERVES SAME AREAS AS M+C HMOs
With congressional negotiators debating how to involve more preferred provider organizatio... Read more
Labs:
PATHOLOGY SERVICES PAYMENTS COULD FACE AN OVERHAUL
Congressional watchdog agency calls for an end to direct Medicare payments. Hospital... Read more
PATHOLOGY SERVICES PAYMENTS COULD FACE AN OVERHAUL
Congressional watchdog agency calls for an end to direct Medicare payments. Hospital... Read more
Pharmaceuticals:
DRUG REBATES REMAIN UNDER OIG'S MICROSCOPE
Feds goad states on Medicaid drug rebate accounting. The Medicaid drug rebate progra... Read more
DRUG REBATES REMAIN UNDER OIG'S MICROSCOPE
Feds goad states on Medicaid drug rebate accounting. The Medicaid drug rebate progra... Read more
Coverage:
COVERAGE EXPANDS,PAY INCREASES FOR VADs
VAD facilities will have to meet accreditation standards.Hospitals that perform heart tran... Read more
COVERAGE EXPANDS,PAY INCREASES FOR VADs
VAD facilities will have to meet accreditation standards.Hospitals that perform heart tran... Read more
TRICARE:
MEDICARE/MEDICAID CLAIMS AREN'T THE ONLY FCA TARGETS
Health care providers should keep in mind that Medicare and Medicaid aren't the only gover... Read more
MEDICARE/MEDICAID CLAIMS AREN'T THE ONLY FCA TARGETS
Health care providers should keep in mind that Medicare and Medicaid aren't the only gover... Read more
HIPAA:
HIPAA SCAMS ON THE RISE
The tell-tale signs of compliance cons - and how to avoid them. From companies offer... Read more
HIPAA SCAMS ON THE RISE
The tell-tale signs of compliance cons - and how to avoid them. From companies offer... Read more
Home Health:
HHAs Brace For Scrutiny Of their Patient Outcomes
Bathing, ambulation, oral meds in the national spotlight. The Oct. 21 deadline for n... Read more
HHAs Brace For Scrutiny Of their Patient Outcomes
Bathing, ambulation, oral meds in the national spotlight. The Oct. 21 deadline for n... Read more
Medicaid:
COULD BUSH PROPOSE PER CAPITA CAP FOR MEDICAID?
The Bush administration continues urging states to accept its capped-funding plan for Medi... Read more
COULD BUSH PROPOSE PER CAPITA CAP FOR MEDICAID?
The Bush administration continues urging states to accept its capped-funding plan for Medi... Read more
Long-Term Care:
CRACKDOWN ON BAD DEBT IS BAD NEWS FOR SNFs
Nursing homes stand to lose thousands of dollars on reimbursement for Medicare bad debt. A... Read more
CRACKDOWN ON BAD DEBT IS BAD NEWS FOR SNFs
Nursing homes stand to lose thousands of dollars on reimbursement for Medicare bad debt. A... Read more
Fraud & Abuse:
HEALTH CARE PROVIDERS STILL UNDER THE GUN
DOJ boast sheet touts record-setting fraud haul. Think health care fraud e... Read more
HEALTH CARE PROVIDERS STILL UNDER THE GUN
DOJ boast sheet touts record-setting fraud haul. Think health care fraud e... Read more
Medicare Reform:
MEDICARE VS. MEDICAID: WHO SHOULD PAY FOR DUAL ELIGIBLES?
The Bush administration continues to believe that people dually eligible for Medicare and ... Read more
MEDICARE VS. MEDICAID: WHO SHOULD PAY FOR DUAL ELIGIBLES?
The Bush administration continues to believe that people dually eligible for Medicare and ... Read more
PBMs:
CHARGES PILE ON IN MEDCO WHISTLEBLOWER SUIT
PBM giant faces False Claims Act charges. It was bad enough for pharmacy benefits ma... Read more
CHARGES PILE ON IN MEDCO WHISTLEBLOWER SUIT
PBM giant faces False Claims Act charges. It was bad enough for pharmacy benefits ma... Read more
DME:
HOW ONE SUPPLIER BEAT OFF THE FEDS IN A WHISTLEBLOWER SUIT
A False Claims Act case is on shaky ground when on one is clear on coding rules. Using the... Read more
HOW ONE SUPPLIER BEAT OFF THE FEDS IN A WHISTLEBLOWER SUIT
A False Claims Act case is on shaky ground when on one is clear on coding rules. Using the... Read more
Physicians:
WHEN A PATIENT TURNS INTO A WHISTLEBLOWER...
Michigan doctor on the line for more than $500,000. Doctors can't be in two pla... Read more
WHEN A PATIENT TURNS INTO A WHISTLEBLOWER...
Michigan doctor on the line for more than $500,000. Doctors can't be in two pla... Read more
BILL WATCH
For the second week in a row, no Medicare or Medicaid bills were introduced in the House ... Read more
For the second week in a row, no Medicare or Medicaid bills were introduced in the House ... Read more
PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services Oct. 1 released the latest round of new w... Read more
The Centers for Medicare & Medicaid Services Oct. 1 released the latest round of new w... Read more
Enforcement:
WHAT'S IN STORE FOR 2004
The OIG offers a peek at its priorities for the coming 12 months Exclusion from Medicare a... Read more
WHAT'S IN STORE FOR 2004
The OIG offers a peek at its priorities for the coming 12 months Exclusion from Medicare a... Read more
Rehab:
5 WAYS THE NEW 65 PERCENT RULE WILL AFFECT REHAB
Experts reveal the hidden fallout from CMS' recently proposed rule.There's still a lot to ... Read more
5 WAYS THE NEW 65 PERCENT RULE WILL AFFECT REHAB
Experts reveal the hidden fallout from CMS' recently proposed rule.There's still a lot to ... Read more
Home Health:
HHA RATES INCREASE, BUT THE MATH IS COMPLICATED
Hospice billing trickier for new rates.Oct. 1 ushered in a new fiscal year for the governm... Read more
HHA RATES INCREASE, BUT THE MATH IS COMPLICATED
Hospice billing trickier for new rates.Oct. 1 ushered in a new fiscal year for the governm... Read more
Pharmaceuticals:
GENERIC COMPANIES NEXT TARGET IN DRUG PRICING WAR
"Marketing the spread" alleged in sweeping new lawsuit The campaign by state f... Read more
GENERIC COMPANIES NEXT TARGET IN DRUG PRICING WAR
"Marketing the spread" alleged in sweeping new lawsuit The campaign by state f... Read more
Rehab:
THERAPY CAPS GO INTO EFFECT
But therapists still hoping for yet another moratorium next year. Unless and un... Read more
THERAPY CAPS GO INTO EFFECT
But therapists still hoping for yet another moratorium next year. Unless and un... Read more
Coverage:
COVERAGE DECISIONS COULD COME QUICKER
Aggrieved beneficiaries get a fast track in updated Medicare coverage decision process. An... Read more
COVERAGE DECISIONS COULD COME QUICKER
Aggrieved beneficiaries get a fast track in updated Medicare coverage decision process. An... Read more
Home Health:
HHA MARKET STABILIZING, FEDS MAINTAIN
But do publicly traded companies give a clear picture of the industry? If lawma... Read more
HHA MARKET STABILIZING, FEDS MAINTAIN
But do publicly traded companies give a clear picture of the industry? If lawma... Read more
Physicians:
DON'T LET MEDICAL RECORDS COME BACK TO HAUNT YOU
Noted physician sentenced in dialysis billing probe. A 7-year-old entry in a dialysi... Read more
DON'T LET MEDICAL RECORDS COME BACK TO HAUNT YOU
Noted physician sentenced in dialysis billing probe. A 7-year-old entry in a dialysi... Read more
Pharmaceuticals:
DRUGMAKER PRICE-CHANGE RULES DELAYED TO 2004
New recordkeeping requirements to go into effect Jan. 1. The new three-year time lim... Read more
DRUGMAKER PRICE-CHANGE RULES DELAYED TO 2004
New recordkeeping requirements to go into effect Jan. 1. The new three-year time lim... Read more
PROGRAM MEMO ROUNDUP
Hospital-based renal dialysis facilities need to stop using their hospitals' provider numb... Read more
Hospital-based renal dialysis facilities need to stop using their hospitals' provider numb... Read more
DME:
IR Review A Certainty For Operation Wheeler Dealer
Power wheelchair use should be on the rise, disability advocates say. The double th... Read more
IR Review A Certainty For Operation Wheeler Dealer
Power wheelchair use should be on the rise, disability advocates say. The double th... Read more
Medicare Reform:
CONFEREES GET NEW DEADLINE, BUSH PEP TALK
Republican leaders on Capitol Hill have set a new deadline of Oct. 17 for congressional n... Read more
CONFEREES GET NEW DEADLINE, BUSH PEP TALK
Republican leaders on Capitol Hill have set a new deadline of Oct. 17 for congressional n... Read more
Long-Term Care:
LTC Providers Push Feds For Reimbursement Changes
Long-term care providers should keep their three-hole punch handy. The buzz from the recen... Read more
LTC Providers Push Feds For Reimbursement Changes
Long-term care providers should keep their three-hole punch handy. The buzz from the recen... Read more
Home Health:
HHA Outcomes Debut On The Web This Month
The home health quality initiative will be hitting the Web and local newspapers in late O... Read more
HHA Outcomes Debut On The Web This Month
The home health quality initiative will be hitting the Web and local newspapers in late O... Read more
Long-Term Care:
NURSING HOMES CAN FREE UP CNA TIME WITH FEEDING ASSISTANTS
New regulations permit long-term care facilities to hire paid feeding assistants. Nursing... Read more
NURSING HOMES CAN FREE UP CNA TIME WITH FEEDING ASSISTANTS
New regulations permit long-term care facilities to hire paid feeding assistants. Nursing... Read more
HIPAA:
PRIVACY COMPLAINTS STREAM INTO OFFICE FOR CIVIL RIGHTS
The straight dope on the first five months of HIPAA enforcement. Your patients are showing... Read more
PRIVACY COMPLAINTS STREAM INTO OFFICE FOR CIVIL RIGHTS
The straight dope on the first five months of HIPAA enforcement. Your patients are showing... Read more
Regulations:
GET READY FOR A NEW WAY TO LEARN ABOUT MEDICARE CHANGES
CMS' Medicare manuals get a makeover - and they'll soon be online - only. Provider-s... Read more
GET READY FOR A NEW WAY TO LEARN ABOUT MEDICARE CHANGES
CMS' Medicare manuals get a makeover - and they'll soon be online - only. Provider-s... Read more
Medicare+Choice:
Relatively Few Affected By Medicare+Choice Withdrawals
Sixteen health plans are withdrawing from Medicare+Choice or reducing their service area, ... Read more
Relatively Few Affected By Medicare+Choice Withdrawals
Sixteen health plans are withdrawing from Medicare+Choice or reducing their service area, ... Read more
PROGRAM MEMO ROUNDUP
The 2004 update to the Healthcare Common Procedure Coding System will reach Medicare contr... Read more
The 2004 update to the Healthcare Common Procedure Coding System will reach Medicare contr... Read more
BILL WATCH
Bills introduced in the House: H.R. 3189. A bill to amend title XVIII of the Social Securi... Read more
Bills introduced in the House: H.R. 3189. A bill to amend title XVIII of the Social Securi... Read more
MEDICARE REFORM:
GOP, DEMS SUGGEST BIG MEDICARE REVAMP CAN WAIT
Thirteen conservative GOP representatives, all of whom voted "reluctantly" for the House M... Read more
GOP, DEMS SUGGEST BIG MEDICARE REVAMP CAN WAIT
Thirteen conservative GOP representatives, all of whom voted "reluctantly" for the House M... Read more
LAB COPAY PROVISION STILL ON CONFEREES' TABLE
Meanwhile, labs recruit docs to help oppose copays.Though it's been three months since the... Read more
Meanwhile, labs recruit docs to help oppose copays.Though it's been three months since the... Read more
HOME CARE PROVIDERS COULD BENEFIT FROM DELAY
House reps insist on home health copay.Congressional leaders have returned to their Medica... Read more
House reps insist on home health copay.Congressional leaders have returned to their Medica... Read more
Medicare+Choice:
AAHP EXPECTS FEWER PLANS TO WITHDRAW FROM M+C
Plans hopeful Congress will deliver on Medicare reform, funding increases. Things m... Read more
AAHP EXPECTS FEWER PLANS TO WITHDRAW FROM M+C
Plans hopeful Congress will deliver on Medicare reform, funding increases. Things m... Read more
HIPAA:
PROVIDERS GET RELIEF ON HIPAA TRANSACTIONS RULE
Medicare contingency plan will permit non-compliant claims.Health care providers who feare... Read more
PROVIDERS GET RELIEF ON HIPAA TRANSACTIONS RULE
Medicare contingency plan will permit non-compliant claims.Health care providers who feare... Read more
Fraud & Abuse:
OIG EYES EXCESSIVE CHARGES
Clarification may be in store on what could get providers excluded from Medicare. Pr... Read more
OIG EYES EXCESSIVE CHARGES
Clarification may be in store on what could get providers excluded from Medicare. Pr... Read more
DME:
WHEELCHAIRS FLYING OUT OF SHOW-ROOM, COURTESY OF MEDICARE
Feds vow to crack down on those who are riding away with Medicare's money. The feds ... Read more
WHEELCHAIRS FLYING OUT OF SHOW-ROOM, COURTESY OF MEDICARE
Feds vow to crack down on those who are riding away with Medicare's money. The feds ... Read more
Quality:
CMS GETS ORGANIZED ON TRACKING COMPLAINTS
New database to monitor complaints against providers.If patients complains about the quali... Read more
CMS GETS ORGANIZED ON TRACKING COMPLAINTS
New database to monitor complaints against providers.If patients complains about the quali... Read more
Long-Term Care:
QUALITY OF CARE ISSUES CAN LEAD TO FALSE CLAIMS ACT PROBLEMS
Nursing homes can't afford to forget that perceived quality-of-care problems could leave t... Read more
QUALITY OF CARE ISSUES CAN LEAD TO FALSE CLAIMS ACT PROBLEMS
Nursing homes can't afford to forget that perceived quality-of-care problems could leave t... Read more
Home Care:
Trainee Services Don't Qualify For Medicare Payment
Home health aide trainees' skills don't have to be wasted, but they won't directly add to ... Read more
Trainee Services Don't Qualify For Medicare Payment
Home health aide trainees' skills don't have to be wasted, but they won't directly add to ... Read more
Medicare+Choice:
MEDPAC: FOLD S/HMOs INTO M+C
The so-called social health maintenance organizations - with which Medicare has experiment... Read more
MEDPAC: FOLD S/HMOs INTO M+C
The so-called social health maintenance organizations - with which Medicare has experiment... Read more
Coverage:
COVERAGE ON THE WAY FOR LVRS
After years of non-coverage, an emphysema treatment is about to get the green light.Health... Read more
COVERAGE ON THE WAY FOR LVRS
After years of non-coverage, an emphysema treatment is about to get the green light.Health... Read more
Home Care:
PRRB Decision Provides Ammo for some HHAs
Medicare beneficiaries are entitled to covered home health services no matter where they l... Read more
PRRB Decision Provides Ammo for some HHAs
Medicare beneficiaries are entitled to covered home health services no matter where they l... Read more
LAB SCAM RINGLEADER WINS RECORD-BREAKING SENTENCE
High profile sentence casts spotlight on lab fraud.A high-profile Sept. 8 fraud sentence ... Read more
High profile sentence casts spotlight on lab fraud.A high-profile Sept. 8 fraud sentence ... Read more
Enforcement:
FEDS HAVE FALSE CLAIMS ACT TARGETS IN HIGH PLACES
Bluegrass State's lieutenant govenor settles FCA suit. When it comes to health care fraud,... Read more
FEDS HAVE FALSE CLAIMS ACT TARGETS IN HIGH PLACES
Bluegrass State's lieutenant govenor settles FCA suit. When it comes to health care fraud,... Read more
Rehab:
DOCTOR'S WORK IS DOCTOR'S WORK
PT clinic operators indicted for lying about physician evals. Two Texas physical the... Read more
DOCTOR'S WORK IS DOCTOR'S WORK
PT clinic operators indicted for lying about physician evals. Two Texas physical the... Read more
Home Care:
BEWARE GIFTS TO REFERRING DOCTORS
Health care marketing practices remain in the cross-hairs - and not just for big pharma.&n... Read more
BEWARE GIFTS TO REFERRING DOCTORS
Health care marketing practices remain in the cross-hairs - and not just for big pharma.&n... Read more
BILL WATCH
The following bill was introduced in the House: H.R. 3090. A bill to amend title XVIII of... Read more
The following bill was introduced in the House: H.R. 3090. A bill to amend title XVIII of... Read more
PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services advised Medicare fiscal intermediaries Se... Read more
The Centers for Medicare & Medicaid Services advised Medicare fiscal intermediaries Se... Read more
Rehab:
RELIEF IN SIGHT ON 75-PERCENT RULE
How does a 65-percent rule sound?Struggling inpatient rehabilitation facilities may be abl... Read more
RELIEF IN SIGHT ON 75-PERCENT RULE
How does a 65-percent rule sound?Struggling inpatient rehabilitation facilities may be abl... Read more
Medicare Reform:
MEDICARE REFORM CONFEREES BICKER AS NEGOTIATIONS CONTINUE
House and Senate Medicare negotiators are meeting this week to vote on tentative agreement... Read more
MEDICARE REFORM CONFEREES BICKER AS NEGOTIATIONS CONTINUE
House and Senate Medicare negotiators are meeting this week to vote on tentative agreement... Read more
Medicare Reform:
DRUG BILL'S E-PROVISIONS are the wRONG PRESCRIPTION, SAY DOCS
Congress should make electronic prescription voluntary, not mandatory, under Medicare pres... Read more
DRUG BILL'S E-PROVISIONS are the wRONG PRESCRIPTION, SAY DOCS
Congress should make electronic prescription voluntary, not mandatory, under Medicare pres... Read more
HOSPITAL FACES EXCLUSIONFROM MEDICARE
OIG pursues "death penalty" against Tenet facility. Exclusion from Medicare: It's one of t... Read more
OIG pursues "death penalty" against Tenet facility. Exclusion from Medicare: It's one of t... Read more
Compliance Watch:
GRANT RECIPIENTS NEXT IN LINE FOR COMPLIANCE GUIDANCE
OIG considers adding eighth core compliance element to existing seven.Compliance program g... Read more
GRANT RECIPIENTS NEXT IN LINE FOR COMPLIANCE GUIDANCE
OIG considers adding eighth core compliance element to existing seven.Compliance program g... Read more
Home Health:
HHAs Caught In The Middle On Supplies Bundling
Home health agencies' failure to report medical supply costs under the prospective payment... Read more
HHAs Caught In The Middle On Supplies Bundling
Home health agencies' failure to report medical supply costs under the prospective payment... Read more
Emergency Medicine:
EMTALA RULE REDUCES OFF-CAMPUS OBLIGATIONS
Under a final rule scheduled for Sept. 9 publication by the Centers for Medicare and Medic... Read more
EMTALA RULE REDUCES OFF-CAMPUS OBLIGATIONS
Under a final rule scheduled for Sept. 9 publication by the Centers for Medicare and Medic... Read more
Pharmaceuticals:
4 SOLUTIONS TO THE OUTPATIENT DRUG PUZZLE
A new world is at hand for Medicare drug payments.Responding to what the feds worry are bi... Read more
4 SOLUTIONS TO THE OUTPATIENT DRUG PUZZLE
A new world is at hand for Medicare drug payments.Responding to what the feds worry are bi... Read more
Managed Care:
PENALTIES INCREASE FOR M+COs
M+C reg has good news and bad.A health plan's cost for terminating a Medi-care+Choice cont... Read more
PENALTIES INCREASE FOR M+COs
M+C reg has good news and bad.A health plan's cost for terminating a Medi-care+Choice cont... Read more
Long-Term Care:
SNFs Win Two Inflation-Related Raises In Medicare Rates
Learn the details to secure your fair share.There's no time like the present for skilled n... Read more
SNFs Win Two Inflation-Related Raises In Medicare Rates
Learn the details to secure your fair share.There's no time like the present for skilled n... Read more
HIPAA:
HOSPITALS CALL FOR HIPAA TRANSACTIONS LIFE-LINE
Has CMS done enough to forestall payment disruptions?Health care providers need more guida... Read more
HOSPITALS CALL FOR HIPAA TRANSACTIONS LIFE-LINE
Has CMS done enough to forestall payment disruptions?Health care providers need more guida... Read more
Physicians:
HOW PICKING THE WRONG BUSINESS PARTNER CAN COST PROVIDERS BIG
Treating a provider number lightly is a dangerous mistake.Traffic in Medicare provider num... Read more
HOW PICKING THE WRONG BUSINESS PARTNER CAN COST PROVIDERS BIG
Treating a provider number lightly is a dangerous mistake.Traffic in Medicare provider num... Read more
Cost Reporting:
MORE PROVIDERS BRACE FOR ELECTRONIC COST REPORTING
Free software in the works for cash-strapped organizations.More types of health care provi... Read more
MORE PROVIDERS BRACE FOR ELECTRONIC COST REPORTING
Free software in the works for cash-strapped organizations.More types of health care provi... Read more
DME:
SUPPLIERS IN FOR CPAP SLAP
Coding change for respiratory assist devices could spell trouble.Durable medical equipment... Read more
SUPPLIERS IN FOR CPAP SLAP
Coding change for respiratory assist devices could spell trouble.Durable medical equipment... Read more
Pharmaceuticals:
Medicare Hatches Plans To Slash DME Drug Payments
Trade group warns of access problems if no service component is added.Durable medical equi... Read more
Medicare Hatches Plans To Slash DME Drug Payments
Trade group warns of access problems if no service component is added.Durable medical equi... Read more
Coding:
CCI EDITS FREE ONLINE
At long last, CMS makes the CCI edts available on its Web site. Physicians who've been she... Read more
CCI EDITS FREE ONLINE
At long last, CMS makes the CCI edts available on its Web site. Physicians who've been she... Read more
Pharmaceuticals:
DRUG REBATES STILL RAISING EYEBROWS WITH THE FEDS
States may get more agressive on rebate collections. The HHS Office of Inspector Gen... Read more
DRUG REBATES STILL RAISING EYEBROWS WITH THE FEDS
States may get more agressive on rebate collections. The HHS Office of Inspector Gen... Read more
Pharmaceuticals:
DRUGMAKERS SADDLED WITH PRICE-CHANGE LIMITS
There's good news and bad news for drugmakers in new rules on Medicaid rebates. Drugmakers... Read more
DRUGMAKERS SADDLED WITH PRICE-CHANGE LIMITS
There's good news and bad news for drugmakers in new rules on Medicaid rebates. Drugmakers... Read more
Physicians:
MORE REIMBURSEMENT FOR PNEUMOCOCCAL VACCINE
Good news for physicians planning to buy ahead.Physicians will collect higher Part B payme... Read more
MORE REIMBURSEMENT FOR PNEUMOCOCCAL VACCINE
Good news for physicians planning to buy ahead.Physicians will collect higher Part B payme... Read more
PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services has added a trio of new "K" codes for bil... Read more
The Centers for Medicare & Medicaid Services has added a trio of new "K" codes for bil... Read more
TENET FACES MORE SCRUTINY OF PHYSICIAN RELATIONSHIPS
This time, state fraud fighters in Florida are investigating the hospital chain.Fraud figh... Read more
This time, state fraud fighters in Florida are investigating the hospital chain.Fraud figh... Read more
MEDICARE PAY CUT LOOMING IN 2004
Only a few months after Congress turned a looming 4.4 percent Medicare pay cut into a 1.6 ... Read more
Only a few months after Congress turned a looming 4.4 percent Medicare pay cut into a 1.6 ... Read more
Dozens of Physician Procedures Slashed in 2004 Fee Schedule
99311, 45385, 99348 among hardest hit.Physicians who see lots of patients in the nursing h... Read more
99311, 45385, 99348 among hardest hit.Physicians who see lots of patients in the nursing h... Read more
ELECTRONIC CLAIMS EXCEPTIONS FEW AND FAR BETWEEN
Providers should get ready to go electronic with their Medicare claims.When the Health Ins... Read more
Providers should get ready to go electronic with their Medicare claims.When the Health Ins... Read more
Top 4 Bases for Liability Under the False claims act
Learn these federal no-nos and prevent unwitting fraud.When the government cracks down on ... Read more
Learn these federal no-nos and prevent unwitting fraud.When the government cracks down on ... Read more
EVERYONE DISLIKES AWP, BUTDOCS DISLIKE PROPOSED FIXES
Medicare beneficiaries and the government could save up to $45.2 billion over ten years if... Read more
Medicare beneficiaries and the government could save up to $45.2 billion over ten years if... Read more
CMS SEEKS COMMENT ON FOUR PAYMENT SCHEMES
According to the Centers for Medicare & Medicaid Services, increasing practice expense... Read more
According to the Centers for Medicare & Medicaid Services, increasing practice expense... Read more
THREE-DAY INPATIENT STAY RULE VEXES SNFs, FEDS
The OIG thinks nursing homes are bungling hospital stay dataSkilled nursing facilities who... Read more
The OIG thinks nursing homes are bungling hospital stay dataSkilled nursing facilities who... Read more
Medicaid Probe Drives Supplier Out Of Business
DME suppliers should repeat this mantra: documentation, documentation, documentation... Read more
DME suppliers should repeat this mantra: documentation, documentation, documentation... Read more
HEALTH CARE EXECS BEWARE
Post-Enron hostility to corporate fraud takes its toll on a lab exec.The growing disgust w... Read more
Post-Enron hostility to corporate fraud takes its toll on a lab exec.The growing disgust w... Read more
FEDS SEEK INFO ON BRISTOL-MYERS COMPLIANCE REVIEW
Internal review covers sales, marketing and pricing practices.As government scrutiny build... Read more
Internal review covers sales, marketing and pricing practices.As government scrutiny build... Read more
ONLINE MEDICARE RESOURCES GET A LITTLE LESS COMPLICATED
CMS unsnarls a tangled web.Confused by the sometimes-labyrinthine experience of navigating... Read more
CMS unsnarls a tangled web.Confused by the sometimes-labyrinthine experience of navigating... Read more
M+C benes Spending More, But FFS Benes Spending even More
The average Medicare+Choice enrollee is spending about $1,964 out-of-pocket this year, 10 ... Read more
The average Medicare+Choice enrollee is spending about $1,964 out-of-pocket this year, 10 ... Read more
PROGRAM MEMO ROUNDUP
The interest rate for Medicare overpayments and underpayments went up August 11, rising fr... Read more
The interest rate for Medicare overpayments and underpayments went up August 11, rising fr... Read more
Long-Term Care:
BETTER PAY FOR HIGH-QUALITY CARE?
SNFs must prepare for a proposed link between payment and QI data. If a skilled nursing f... Read more
BETTER PAY FOR HIGH-QUALITY CARE?
SNFs must prepare for a proposed link between payment and QI data. If a skilled nursing f... Read more
HIPAA:
HIPAA, UNPREPARED PROVIDERS COULD CAUSE CLAIMS NIGHTMARES
Some provider groups are predicting a claims "train wreck." Three months before the Healt... Read more
HIPAA, UNPREPARED PROVIDERS COULD CAUSE CLAIMS NIGHTMARES
Some provider groups are predicting a claims "train wreck." Three months before the Healt... Read more
Long-TermCare:
WHAT THE 2004 ADJUSTMENTS MEAN FOR NURSING HOMES
Industry braces for much-needed cash infusion. Skilled nursing facilities are in for a si... Read more
WHAT THE 2004 ADJUSTMENTS MEAN FOR NURSING HOMES
Industry braces for much-needed cash infusion. Skilled nursing facilities are in for a si... Read more
Medicare Reform:
DISCOUNT CARD AGREEMENT PUTS MOMENTUM BACK IN MEDICARE REFORM NEGOTIATIONS... BUT FOR HOW LONG?
House and Senate Medicare conferees have reached a "tentative agreement" on rules for pres... Read more
DISCOUNT CARD AGREEMENT PUTS MOMENTUM BACK IN MEDICARE REFORM NEGOTIATIONS... BUT FOR HOW LONG?
House and Senate Medicare conferees have reached a "tentative agreement" on rules for pres... Read more
HealthPlans:
WHY HEALTH PLANS HATE THE IDEA OF MEDICARE 'REGIONS'
The White House, House, and Senate all want to ensure health-plan choices for Medicare ben... Read more
WHY HEALTH PLANS HATE THE IDEA OF MEDICARE 'REGIONS'
The White House, House, and Senate all want to ensure health-plan choices for Medicare ben... Read more
DME:
WHEN IS IT OK TO GIVE A FREE UPGRADE?
It's more often than you might think. Some suppliers might be scared off from furnishing ... Read more
WHEN IS IT OK TO GIVE A FREE UPGRADE?
It's more often than you might think. Some suppliers might be scared off from furnishing ... Read more
Rehab:
WHAT'S MISSING FROM THE 2004 IRF PAYMENT UPDATE
Controversial 75 percent rule still unsettled. Inpatient rehabilitation facilities will g... Read more
WHAT'S MISSING FROM THE 2004 IRF PAYMENT UPDATE
Controversial 75 percent rule still unsettled. Inpatient rehabilitation facilities will g... Read more
Hospitals:
CMS PROPOSES 3.8-PERCENT OPPS UPDATE
Hospital payments under the outpatient prospective payment system would get a 3.8-percent ... Read more
CMS PROPOSES 3.8-PERCENT OPPS UPDATE
Hospital payments under the outpatient prospective payment system would get a 3.8-percent ... Read more
Pharmaceuticals:
LOOKING INWARD ON MEDICAID PRICING, REBATES
Sparked by federal scrutiny, drugmakers examine compliance practices. Medicaid rebates an... Read more
LOOKING INWARD ON MEDICAID PRICING, REBATES
Sparked by federal scrutiny, drugmakers examine compliance practices. Medicaid rebates an... Read more
Rehab:
HOW RELATED PARTY ISSUES CAN LAND PROVIDERS IN PRISON
When a compensation package is too good to be true. A Missouri rehab operator capped off ... Read more
HOW RELATED PARTY ISSUES CAN LAND PROVIDERS IN PRISON
When a compensation package is too good to be true. A Missouri rehab operator capped off ... Read more
Physicians:
PHYSICIAN FACES 'SHOCK' PROBATION
Upcoding leads to weekends behind bars Health care fraud enforcers are using the latest t... Read more
PHYSICIAN FACES 'SHOCK' PROBATION
Upcoding leads to weekends behind bars Health care fraud enforcers are using the latest t... Read more
HomeCare:
LAWMAKERS COULD TARGET HOME CARE FOR CUTS
It just may have become more difficult to get negative home care provisions out of - and g... Read more
LAWMAKERS COULD TARGET HOME CARE FOR CUTS
It just may have become more difficult to get negative home care provisions out of - and g... Read more
Medicare+Choice:
2 FLORIDA M+COS BUSTED FOR MARKETING VIOLATIONS
As the competition to enroll Florida seniors in Medicare+Choice plans heats up, more healt... Read more
2 FLORIDA M+COS BUSTED FOR MARKETING VIOLATIONS
As the competition to enroll Florida seniors in Medicare+Choice plans heats up, more healt... Read more
PROGRAM MEMO ROUNDUP
Starting Jan. 1, 2004, patients will have a better sense of what's going on if claims get ... Read more
Starting Jan. 1, 2004, patients will have a better sense of what's going on if claims get ... Read more
Labs:
LABS HAVE LOTS TO LOSE IN COPAY CONFLICT
New Bill Jeopardizes Ove $18 Billion in Lab Revenues Just when labs thought it was s... Read more
LABS HAVE LOTS TO LOSE IN COPAY CONFLICT
New Bill Jeopardizes Ove $18 Billion in Lab Revenues Just when labs thought it was s... Read more
Medicare Rx:
IF MEDICARE Rx BILL HAPPENS, E-PRESCRIBING WINS THE DAY
If this year's Medicare prescription-drug legislation becomes law, expect the country to s... Read more
IF MEDICARE Rx BILL HAPPENS, E-PRESCRIBING WINS THE DAY
If this year's Medicare prescription-drug legislation becomes law, expect the country to s... Read more
HIPAA:
TRANSACTION RULE ENFORCEMENT FORECAST
CMS tips its hand on how it will handle post Oct. 16 TCS compliance violations ... Read more
TRANSACTION RULE ENFORCEMENT FORECAST
CMS tips its hand on how it will handle post Oct. 16 TCS compliance violations ... Read more
Medicare Rx:
WHITE HOUSE: 'WE WANT A DEAL'
The president wants to sign a Medicare prescription drug bill this year, and in the end he... Read more
WHITE HOUSE: 'WE WANT A DEAL'
The president wants to sign a Medicare prescription drug bill this year, and in the end he... Read more
Medicare Rx:
MEDICARE CONFEREES AIM FOR MID-SEPTEMBER WRAP-UP
House and Senate Medicare negotiators on July 24 announced agreement on relatively uncontr... Read more
MEDICARE CONFEREES AIM FOR MID-SEPTEMBER WRAP-UP
House and Senate Medicare negotiators on July 24 announced agreement on relatively uncontr... Read more
Home Health:
ABNs Vital To DME Upgrade Payments
Medicare now gives beneficiaries the option of paying for the difference between a Medicar... Read more
ABNs Vital To DME Upgrade Payments
Medicare now gives beneficiaries the option of paying for the difference between a Medicar... Read more
Pharmaceuticals:
SCRUTINY CONTINUES ON DRUG REBATES
Feds want states to get tough on hot-button issue for drugmakers If you haven't got... Read more
SCRUTINY CONTINUES ON DRUG REBATES
Feds want states to get tough on hot-button issue for drugmakers If you haven't got... Read more
Whistleblowers:
DOC TARGETS WINDY CITY HOSPITALS IN TRANSPLANT QUI TAM
Feds seek big money from one facility, but co-defendants settle cheap Allegedly lyi... Read more
DOC TARGETS WINDY CITY HOSPITALS IN TRANSPLANT QUI TAM
Feds seek big money from one facility, but co-defendants settle cheap Allegedly lyi... Read more
Hospitals:
CONSOLIDATING HOSPITALS MUST MIND THEIR Ps AND Qs
Hospitals that consolidate their operations need to make sure their subsequent Medicare bi... Read more
CONSOLIDATING HOSPITALS MUST MIND THEIR Ps AND Qs
Hospitals that consolidate their operations need to make sure their subsequent Medicare bi... Read more
BILL WATCH
Bills introduced in the House: H.R. 2817. A bill to provide that the actuarial value of t... Read more
Bills introduced in the House: H.R. 2817. A bill to provide that the actuarial value of t... Read more
REGISTER WATCH
As is now routine for the last Friday of each month, the Centers for Medicare & Medica... Read more
As is now routine for the last Friday of each month, the Centers for Medicare & Medica... Read more
PROGRAM MEMO ROUNDUP
Nursing homes and home health agencies, take note: Fiscal intermediaries will no longer be... Read more
Nursing homes and home health agencies, take note: Fiscal intermediaries will no longer be... Read more
Hospitals:
Can A Physician Relocation Agreement Be A Kickback?
Feds slap Tenet facility with criminal charges. In what could prove to be the beginning o... Read more
Can A Physician Relocation Agreement Be A Kickback?
Feds slap Tenet facility with criminal charges. In what could prove to be the beginning o... Read more
Medicare Rx:
AARP Gives Reform Plan
Opposition from powerful group could alter course of reform bill. Various associations and... Read more
AARP Gives Reform Plan
Opposition from powerful group could alter course of reform bill. Various associations and... Read more
HIPAA:
Providers Rally For Transaction Standard Relief
Will the feds act to avert a HIPAA "train wreck"? Is anyone ready for the Oct. 16 Health I... Read more
Providers Rally For Transaction Standard Relief
Will the feds act to avert a HIPAA "train wreck"? Is anyone ready for the Oct. 16 Health I... Read more
Home Health:
HHAs Prepare For A Waiver Crackdown
Waiver providers should expect more audits and fraud charges. The trend of more regulatory... Read more
HHAs Prepare For A Waiver Crackdown
Waiver providers should expect more audits and fraud charges. The trend of more regulatory... Read more
Long-Term Care:
Watch For Tougher Nursing Home Surveys
Nursing homes may be in for more scrutiny.Nursing homes may think that surveys have gotten... Read more
Watch For Tougher Nursing Home Surveys
Nursing homes may be in for more scrutiny.Nursing homes may think that surveys have gotten... Read more
Transport Services:
Ambulances Pursued By Federal Sirens
Medical transportation companies are coming under increasing scrutiny by state and federal... Read more
Ambulances Pursued By Federal Sirens
Medical transportation companies are coming under increasing scrutiny by state and federal... Read more
Hospitals:
Medicaid Official Blows Whistle On Provider
A Miami hospital will pay a whopping $16.8 million to settle a whistleblower suit filed by... Read more
Medicaid Official Blows Whistle On Provider
A Miami hospital will pay a whopping $16.8 million to settle a whistleblower suit filed by... Read more
Rehab:
Therapist Nabbed For 'Incident To' Improprieties
Rehab owner pleads guilty to billing fraud in Medicare probe.Playing fast and loose with a... Read more
Therapist Nabbed For 'Incident To' Improprieties
Rehab owner pleads guilty to billing fraud in Medicare probe.Playing fast and loose with a... Read more
Home Health:
CMN No Longer Required For DME Repairs
Good news on diagnosis coding trickles down to DMERCs as well. Suppliers can cross at lea... Read more
CMN No Longer Required For DME Repairs
Good news on diagnosis coding trickles down to DMERCs as well. Suppliers can cross at lea... Read more
DME:
Medicaid Probe Drives Supplier Out Of Business
Investigation centers on 3 compliance areas.Durable medical equipment suppliers can't affo... Read more
Medicaid Probe Drives Supplier Out Of Business
Investigation centers on 3 compliance areas.Durable medical equipment suppliers can't affo... Read more
Medicare Coverage:
EEOC Proposes Coordination Of Retiree Benefits With Medicare
An employer could offer less generous health coverage for older retirees eligible for Medi... Read more
EEOC Proposes Coordination Of Retiree Benefits With Medicare
An employer could offer less generous health coverage for older retirees eligible for Medi... Read more
Long-Term Care:
SNFs Should Watch Their Med Procedures
Here's what CMS wants surveyors to look for. Nursing homes getting surveyed may soon find ... Read more
SNFs Should Watch Their Med Procedures
Here's what CMS wants surveyors to look for. Nursing homes getting surveyed may soon find ... Read more
Quality:
Quality Reviews Just Got Less Private
QIOs to disclose more to patients. Health care providers should be aware that patients wi... Read more
Quality Reviews Just Got Less Private
QIOs to disclose more to patients. Health care providers should be aware that patients wi... Read more
MedicareRx:
REFORM BILLS COULD CHANGE GREATLY DURING CONFERENCE
The final draft placed on president's desk could be quite different from either bill. Now ... Read more
REFORM BILLS COULD CHANGE GREATLY DURING CONFERENCE
The final draft placed on president's desk could be quite different from either bill. Now ... Read more
HealthPlans:
HEALTH PLANS SAY REFORM BILLS WILL CONSTRAIN MARKET
The administration has put its weight behind a Medicare private-plan structure that would ... Read more
HEALTH PLANS SAY REFORM BILLS WILL CONSTRAIN MARKET
The administration has put its weight behind a Medicare private-plan structure that would ... Read more
HomeHealth:
HOME HEALTH INDUSTRY HAS MUCH AT STAKE IN REFORM BILLS
Background Check Proposal Catches HHAs By Surprise. The Medicare bills passed by the House... Read more
HOME HEALTH INDUSTRY HAS MUCH AT STAKE IN REFORM BILLS
Background Check Proposal Catches HHAs By Surprise. The Medicare bills passed by the House... Read more
Rehab:
THERAPISTS WIN RESPITE ON THERAPY CAP
Eleventh-hour decision delays dreaded reimbursement cap-but will the delay be long enough?... Read more
THERAPISTS WIN RESPITE ON THERAPY CAP
Eleventh-hour decision delays dreaded reimbursement cap-but will the delay be long enough?... Read more
Physicians:
MORE INFO ON PHYSICIANS GOES ONLINE
Medicare beneficiaries get more details on doctors. More information on more physicians is... Read more
MORE INFO ON PHYSICIANS GOES ONLINE
Medicare beneficiaries get more details on doctors. More information on more physicians is... Read more
Physicians:
DOCS NOT RESPONSIBLE FOR RETROACTIVE OVERPAYMENTS
Physicians' summer won't be as bleak as feared. Physicians won't have to cough up overpaym... Read more
DOCS NOT RESPONSIBLE FOR RETROACTIVE OVERPAYMENTS
Physicians' summer won't be as bleak as feared. Physicians won't have to cough up overpaym... Read more
HomeHealth:
MEDICARE BUMPS UP HHA RATES 3.3% IN 2004
Home health agencies will see a nice little increase in Medicare payment rates come Octobe... Read more
MEDICARE BUMPS UP HHA RATES 3.3% IN 2004
Home health agencies will see a nice little increase in Medicare payment rates come Octobe... Read more
Hospitals:
CMS, PREMIER LAUNCH PAY-FOR-PERFORMANCE DEMO
Starting next year, top performing hospitals can get a boost in their Medicare reimburseme... Read more
CMS, PREMIER LAUNCH PAY-FOR-PERFORMANCE DEMO
Starting next year, top performing hospitals can get a boost in their Medicare reimburseme... Read more
Hospice:
INCREASED MEDICARE RATES ON DECK FOR HOSPICE
Community networking, fundraising key to staying in the black If the payment increase off... Read more
INCREASED MEDICARE RATES ON DECK FOR HOSPICE
Community networking, fundraising key to staying in the black If the payment increase off... Read more
Hospitals:
TENET OUTLIERS FACE MORE SCRUTINY
Federal agencies gang up on hospital giant. Yet another federal agency is looking into bel... Read more
TENET OUTLIERS FACE MORE SCRUTINY
Federal agencies gang up on hospital giant. Yet another federal agency is looking into bel... Read more
BILL WATCH/REGISTER WATCH/PROGRAM MEMO ROUNDUP
BILL WATCHBills introduced in the House: H.R. 2664. A bill to provide for Medicare reimbur... Read more
BILL WATCHBills introduced in the House: H.R. 2664. A bill to provide for Medicare reimbur... Read more
Fraud&Abuse:
10 KEY MEDICARE/MEDICAID ENFORCEMENT AREAS
OIG's acting chief tells what her agency is worried about. Despite years of stepped up enf... Read more
10 KEY MEDICARE/MEDICAID ENFORCEMENT AREAS
OIG's acting chief tells what her agency is worried about. Despite years of stepped up enf... Read more
Medicare Rx:
HOUSE AND SENATE VOTE TO OVERHAUL MEDICARE
In the early morning hours of June 27, both the House and the Senate passed bills that wou... Read more
HOUSE AND SENATE VOTE TO OVERHAUL MEDICARE
In the early morning hours of June 27, both the House and the Senate passed bills that wou... Read more
Medicare Perspectives:
MEDICARE Rx: EVEN WHEN IT'S OVER, IT WON'T BE OVER
Medicare legislation to add a prescription-drug benefit and inject more private health-pla... Read more
MEDICARE Rx: EVEN WHEN IT'S OVER, IT WON'T BE OVER
Medicare legislation to add a prescription-drug benefit and inject more private health-pla... Read more
QIOs:
COURT: QIOS MUST TELL COMPLAINING SENIORS MORE
A Medicare quality improvement organization must tell a complaining beneficiary, at a mini... Read more
COURT: QIOS MUST TELL COMPLAINING SENIORS MORE
A Medicare quality improvement organization must tell a complaining beneficiary, at a mini... Read more
Uninsured:
EXPANDING COVERAGE IS WORTH IT FOR ALL, IOM PANEL INSISTS
Many Americans fail to reach their developmental potential, and public programs like Medic... Read more
EXPANDING COVERAGE IS WORTH IT FOR ALL, IOM PANEL INSISTS
Many Americans fail to reach their developmental potential, and public programs like Medic... Read more
PBMs:
PBM TARGETED IN NEW WHISTLEBLOWER SUIT
Enforcement trends spell trouble for drug industry and its business partners "Follow the ... Read more
PBM TARGETED IN NEW WHISTLEBLOWER SUIT
Enforcement trends spell trouble for drug industry and its business partners "Follow the ... Read more
Overpayments:
WHITE HOUSE OVERPAYMENT GUIDANCE HITS YOUR BOTTOM LINE
Well documented claims are more important than ever Your chances of being targeted for pa... Read more
WHITE HOUSE OVERPAYMENT GUIDANCE HITS YOUR BOTTOM LINE
Well documented claims are more important than ever Your chances of being targeted for pa... Read more
Business Arrangements:
MRI JV PASSES OIG MUSTER
Four key elements win over the feds Despite the HHS Office of Inspector General's longsta... Read more
MRI JV PASSES OIG MUSTER
Four key elements win over the feds Despite the HHS Office of Inspector General's longsta... Read more
Physicians:
DOCS GET RELIEF ON FEE SCHEDULE ADJUSTMENT
Potential cash flow mess averted Good news for doctors: Physicians won't have to cough ... Read more
DOCS GET RELIEF ON FEE SCHEDULE ADJUSTMENT
Potential cash flow mess averted Good news for doctors: Physicians won't have to cough ... Read more
Home Health:
HHAs IN LINE FOR 3.3 PERCENT RAISE
PPS update in line with expectations Home health agency Medicare payment rates will go up... Read more
HHAs IN LINE FOR 3.3 PERCENT RAISE
PPS update in line with expectations Home health agency Medicare payment rates will go up... Read more
BILL WATCH
The following House bills were introduced: H.R. 2560. A bill to amend title XVIII of the S... Read more
The following House bills were introduced: H.R. 2560. A bill to amend title XVIII of the S... Read more
Medicare Rx:
MEDICARE OVERHAUL ADVANCES IN HOUSE
Medicare beneficiaries would receive 100 percent coverage of drug expenses after spending ... Read more
MEDICARE OVERHAUL ADVANCES IN HOUSE
Medicare beneficiaries would receive 100 percent coverage of drug expenses after spending ... Read more
Medicare Rx:
SENATE BILL STILL ON PATH TO PASSAGE
In the Senate, there is still a ways to go before a final product. However, it's looking m... Read more
SENATE BILL STILL ON PATH TO PASSAGE
In the Senate, there is still a ways to go before a final product. However, it's looking m... Read more
Medicare Rx:
WHITE HOUSE Key To Medicare Reform
Most Democrats supporting Grassley-Baucus would not support the direct competition between... Read more
WHITE HOUSE Key To Medicare Reform
Most Democrats supporting Grassley-Baucus would not support the direct competition between... Read more
Medicare Rx:
FINANCIAL ANALYSTS: DRUG-ONLY PLANS A NO-GO
The Medicare prescription-drug legislation being debated in Washington proposes private dr... Read more
FINANCIAL ANALYSTS: DRUG-ONLY PLANS A NO-GO
The Medicare prescription-drug legislation being debated in Washington proposes private dr... Read more
Specialty Hospitals:
CMS CAN'T, CONGRESS MIGHT CAN WHOLE-HOSPITAL EXEMPTION
The rise of specialty hospitals funded mainly by physician investors is a recent phenomeno... Read more
CMS CAN'T, CONGRESS MIGHT CAN WHOLE-HOSPITAL EXEMPTION
The rise of specialty hospitals funded mainly by physician investors is a recent phenomeno... Read more
MedPAC:
MEDPAC PUSHES PAY FOR MEDPAC PUSHES PAY FOR
To provide high-quality, cost-effective treatment, Medicare must launch demonstration proj... Read more
MEDPAC PUSHES PAY FOR MEDPAC PUSHES PAY FOR
To provide high-quality, cost-effective treatment, Medicare must launch demonstration proj... Read more
Enforcement:
WHAT'S TOPPING FRAUD-FIGHTERS' TO-DO LISTS
Perhaps the top activity for state and federal fraud busters these days is following pharm... Read more
WHAT'S TOPPING FRAUD-FIGHTERS' TO-DO LISTS
Perhaps the top activity for state and federal fraud busters these days is following pharm... Read more
SCHIP:
Finance Acts To Preserve SCHIP Funds
The Senate Finance Committee June 12 unanimously approved legislation to prevent states fr... Read more
Finance Acts To Preserve SCHIP Funds
The Senate Finance Committee June 12 unanimously approved legislation to prevent states fr... Read more
Hospitals:
HOSPITALS OUTCOMES DEMO TO GO FORWARD
Agreement has been reached on terms of a Medicare demonstration project that would give ho... Read more
HOSPITALS OUTCOMES DEMO TO GO FORWARD
Agreement has been reached on terms of a Medicare demonstration project that would give ho... Read more
Hospitals:
BEEF UP YOUR POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforc... Read more
BEEF UP YOUR POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforc... Read more
Hospitals:
SMALL FACILITIES HIT HARDEST BY CLOSURES
In rural and urban settings alike, smaller hospitals that treat fewer patients than their ... Read more
SMALL FACILITIES HIT HARDEST BY CLOSURES
In rural and urban settings alike, smaller hospitals that treat fewer patients than their ... Read more
Coverage:
CMS Settles Appeals Suit
Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commi... Read more
CMS Settles Appeals Suit
Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commi... Read more
Coverage:
ICD COVERAGE EXPANDS- BUT ONLY SLIGHTLY
Health care providers will soon be able to bill Medicare for implantable cardioverter defi... Read more
ICD COVERAGE EXPANDS- BUT ONLY SLIGHTLY
Health care providers will soon be able to bill Medicare for implantable cardioverter defi... Read more
Bill Watch
The following House bills were introduced: H.R. 2471. A bill to amend title XVIII of the ... Read more
The following House bills were introduced: H.R. 2471. A bill to amend title XVIII of the ... Read more
Register Watch
Looking for continuing education credits? Look to CMS. The Centers for Medicare & Medi... Read more
Looking for continuing education credits? Look to CMS. The Centers for Medicare & Medi... Read more
Medicare:
SENATE FINANCE APPROVES
After an all-day June 12 mark-up, the Senate Finance Committee approved a bill that would ... Read more
SENATE FINANCE APPROVES
After an all-day June 12 mark-up, the Senate Finance Committee approved a bill that would ... Read more
Hospitals:
HOSPITALS BRACE FOR NEW OUTLIER POLICIES
Only a small number of hospitals will have to go through the onerous process of reconcilin... Read more
HOSPITALS BRACE FOR NEW OUTLIER POLICIES
Only a small number of hospitals will have to go through the onerous process of reconcilin... Read more
Long-Term Care:
LONG-TERM CARE PROPOSAL COULD PROVIDE SHORT-TERM HELP
But a new CMS SNF payment policy cut both ways.Skilled nursing facilities would get a paym... Read more
LONG-TERM CARE PROPOSAL COULD PROVIDE SHORT-TERM HELP
But a new CMS SNF payment policy cut both ways.Skilled nursing facilities would get a paym... Read more
Enforcement :
AN EVEN TOUGHER WHISTLEBLOWER LAW?
A move is afoot to up the stakes yet again in the ongoing campaign against health care fra... Read more
AN EVEN TOUGHER WHISTLEBLOWER LAW?
A move is afoot to up the stakes yet again in the ongoing campaign against health care fra... Read more
Ambulance:
KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS
The HHS Office of Inspector General has its eye on ambulance providers who submit Medicaid... Read more
KNOW WHO TO BILL WHEN TRANSPORTING HOSPITALIZED PATIENTS
The HHS Office of Inspector General has its eye on ambulance providers who submit Medicaid... Read more
Medicare+Choice:
WATERED-DOWN Rx PROPOSAL STILL STRONG ENOUGH TO HELP M+COs
Medicare+Choice plans that have been holding on in hopes of being saved by a prescription ... Read more
WATERED-DOWN Rx PROPOSAL STILL STRONG ENOUGH TO HELP M+COs
Medicare+Choice plans that have been holding on in hopes of being saved by a prescription ... Read more
Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk coul... Read more
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk coul... Read more
People:
GAO LETS LOOSE PARTING BLOW AGAINST EX-OIG CHIEF
The General Accounting Office gave former HHS Office of Inspector General chief Janet Rehn... Read more
GAO LETS LOOSE PARTING BLOW AGAINST EX-OIG CHIEF
The General Accounting Office gave former HHS Office of Inspector General chief Janet Rehn... Read more
Quality of Care:
DOLLARS FOR QUALITY
Hospitals could soon collect bonuses from Medicare for delivering high-quality care. The ... Read more
DOLLARS FOR QUALITY
Hospitals could soon collect bonuses from Medicare for delivering high-quality care. The ... Read more
Labs:
SUMMER SURVEYS MAY OFFER SLIMMER CITATIONS
What Will CLIA Inspecions Look Like This Season?Who says there ain't no cure for the summe... Read more
SUMMER SURVEYS MAY OFFER SLIMMER CITATIONS
What Will CLIA Inspecions Look Like This Season?Who says there ain't no cure for the summe... Read more
Pharmaceuticals:
BALDACCI INTRODUCES REVISED MAINE Rx
Maine Governor John Baldacci has proposed a revised version of the state's Maine Rx initia... Read more
BALDACCI INTRODUCES REVISED MAINE Rx
Maine Governor John Baldacci has proposed a revised version of the state's Maine Rx initia... Read more
Pharmaceuticals:
WYDEN: NIH IGNORED PATIENT, TAXPAYER COSTS FOR TAXOL
The National Institutes of Health had the authority to get a better deal for taxpayers and... Read more
WYDEN: NIH IGNORED PATIENT, TAXPAYER COSTS FOR TAXOL
The National Institutes of Health had the authority to get a better deal for taxpayers and... Read more
Fraud & Abuse:
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk coul... Read more
LIE TO AN AUDITOR, LINGER IN JAIL
When it comes to dealing with Medicare and Medicaid auditors, a lack of straight talk coul... Read more
DME:
PAY A BENEFICIARY, PAY THE PRICE
Mult-million-dollar fraud case keeps DME suppliers in the enforcement cross hairs. Paying ... Read more
PAY A BENEFICIARY, PAY THE PRICE
Mult-million-dollar fraud case keeps DME suppliers in the enforcement cross hairs. Paying ... Read more
Bill Watch
The following bills were introduced in the House: H.R. 2423. A bill to amend title XVIII ... Read more
The following bills were introduced in the House: H.R. 2423. A bill to amend title XVIII ... Read more
PROGRAM MEMO ROUNDUP
Starting Oct. 1, if you don't include an ICD-9-CM diagnosis code on your Part B claims, yo... Read more
Starting Oct. 1, if you don't include an ICD-9-CM diagnosis code on your Part B claims, yo... Read more
Register Watch
The Centers for Medicare & Medicaid Services asked for comments on extension of two in... Read more
The Centers for Medicare & Medicaid Services asked for comments on extension of two in... Read more
Medicare Private Plans:
PPOs WON'T PROLONG MEDICARE SOLVENCY, SAYS CMS
Adding preferred provider organizations to Medicare, as the White House strongly advocates... Read more
PPOs WON'T PROLONG MEDICARE SOLVENCY, SAYS CMS
Adding preferred provider organizations to Medicare, as the White House strongly advocates... Read more
Pharmaceuticals:
Senate Finance Produces Bipartisan Rx Plan
Senate Finance Committee Chair Chuck Grassley (R-IA) and ranking Democrat Max Baucus (DMT)... Read more
Senate Finance Produces Bipartisan Rx Plan
Senate Finance Committee Chair Chuck Grassley (R-IA) and ranking Democrat Max Baucus (DMT)... Read more
Hospitals:
CMS ISSUES FINAL OUTLIER RULE
Hospitals will have until Oct. 1, 2003, before their most up-to-date cost data is used to ... Read more
CMS ISSUES FINAL OUTLIER RULE
Hospitals will have until Oct. 1, 2003, before their most up-to-date cost data is used to ... Read more
Hospitals:
RECRUITMENT PLAN DRAWS FEDS' IRE
Double-Check Your Physician Relocation Programs The controversial intersection between p... Read more
RECRUITMENT PLAN DRAWS FEDS' IRE
Double-Check Your Physician Relocation Programs The controversial intersection between p... Read more
Pharmaceuticals:
PHARMA ENFORCEMENT REACHES A BOIL
Drug Giant Targeted In Criminal Probe The aggressive health care fraud enforcement team ... Read more
PHARMA ENFORCEMENT REACHES A BOIL
Drug Giant Targeted In Criminal Probe The aggressive health care fraud enforcement team ... Read more
Fraud & Abuse:
200 PROVIDERS EXCLUDED PER MONTH
Medicaid rebates were at the center of the biggest health care fraud settlement over the l... Read more
200 PROVIDERS EXCLUDED PER MONTH
Medicaid rebates were at the center of the biggest health care fraud settlement over the l... Read more
Business Arrangements:
RADIOLOGIST-HOSPITAL JV CLEARS ANTI-KICKBACK HURDLES
Other Specialties Could Face Trickier Path The fact that radiologists don't typically or... Read more
RADIOLOGIST-HOSPITAL JV CLEARS ANTI-KICKBACK HURDLES
Other Specialties Could Face Trickier Path The fact that radiologists don't typically or... Read more
HIPAA:
KNOW WHEN NOT TO SECURE A BUSINESS ASSOCIATE AGREEMENT
Health care providers and plans may not have as many Health Insurance Portability and Acco... Read more
KNOW WHEN NOT TO SECURE A BUSINESS ASSOCIATE AGREEMENT
Health care providers and plans may not have as many Health Insurance Portability and Acco... Read more
Long-Term Care:
LTCHs SET FOR 2.5 PERCENT RAISE
So Long, Satellite Bed Restrictions Long-term care hospitals won't have to deal with pot... Read more
LTCHs SET FOR 2.5 PERCENT RAISE
So Long, Satellite Bed Restrictions Long-term care hospitals won't have to deal with pot... Read more
Hospice:
JCAHO STAYS ON FOR HOSPICE ACCREDITATION
The Joint Commission on Accreditation of Healthcare Organizations will serve as a national... Read more
JCAHO STAYS ON FOR HOSPICE ACCREDITATION
The Joint Commission on Accreditation of Healthcare Organizations will serve as a national... Read more
Reimbursement :
DSH PITFALLS EMERGE IN OIG SCRUTINY
If you've had your disproportionate share hospital payment calculations challenged for inc... Read more
DSH PITFALLS EMERGE IN OIG SCRUTINY
If you've had your disproportionate share hospital payment calculations challenged for inc... Read more
Bill Watch
The following bills were introduced in the House: H.R. 2323. A bill to amend to the Socia... Read more
The following bills were introduced in the House: H.R. 2323. A bill to amend to the Socia... Read more
Register Watch
The end-stage renal disease demonstration program, announced by Centers for Medicare &... Read more
The end-stage renal disease demonstration program, announced by Centers for Medicare &... Read more
PROGRAM MEMO ROUNDUP
Home health agencies in Connecticut and Massachusetts may be in line for a paperwork break... Read more
Home health agencies in Connecticut and Massachusetts may be in line for a paperwork break... Read more
Medicare:
BUSHIES SOFTENING ON MEDICARE REFORM?
So far, House and Senate bills being drafted to add a prescription drug benefit are "clear... Read more
BUSHIES SOFTENING ON MEDICARE REFORM?
So far, House and Senate bills being drafted to add a prescription drug benefit are "clear... Read more
Rehab:
WILL CONGRESS WALLOP REHAB CAPS A KNOCKOUT PUNCH?
The answer could mean the world to many facilities With the July 1 implementation d... Read more
WILL CONGRESS WALLOP REHAB CAPS A KNOCKOUT PUNCH?
The answer could mean the world to many facilities With the July 1 implementation d... Read more
ESRD:
CMS LAUNCHES ESRD DEMO
A new four-year Medicare demonstration program offers end-stage renal disease providers tw... Read more
CMS LAUNCHES ESRD DEMO
A new four-year Medicare demonstration program offers end-stage renal disease providers tw... Read more
HIPAA:
HIPAA STANDARD DATEBOOK
Your Heads-Up On Upcoming HIPAA Requirements Mark your calendars: The Centers for Medicare... Read more
HIPAA STANDARD DATEBOOK
Your Heads-Up On Upcoming HIPAA Requirements Mark your calendars: The Centers for Medicare... Read more
Hospitals:
Pay-For-Quality Hospital Demo In Works
The Centers for Medicare & Medicaid Services hopes to soon announce a demonstration th... Read more
Pay-For-Quality Hospital Demo In Works
The Centers for Medicare & Medicaid Services hopes to soon announce a demonstration th... Read more
Trends:
HIGHER COSTS, MORE COST SHARING IN HSC FORECAST
Health care costs continue to increase rapidly, employers are shifting more costs to emplo... Read more
HIGHER COSTS, MORE COST SHARING IN HSC FORECAST
Health care costs continue to increase rapidly, employers are shifting more costs to emplo... Read more
KNOW WHAT'S COMING ON THE REGULATORY FRONT:
HHS PLANS NEW RULES ON SELF-REFERRAL, KICKBACKS AND EMTALA
Physicians' business relationships with other health care providers could be in for a shak... Read more
HHS PLANS NEW RULES ON SELF-REFERRAL, KICKBACKS AND EMTALA
Physicians' business relationships with other health care providers could be in for a shak... Read more
HIPAA:
PROVIDERS SEEK HIPAA TCS ASSURANCES
Are you ready for what the Oct. 16 Health Insurance Portability and Accountability Act tra... Read more
PROVIDERS SEEK HIPAA TCS ASSURANCES
Are you ready for what the Oct. 16 Health Insurance Portability and Accountability Act tra... Read more
Ambulance:
AMBULANCE SUBSCRIPTION PLAN STEERS PAST KICKBACK PERILS
Ambulance companies that charge an annual subscription fee in lieu of collecting Medicare ... Read more
AMBULANCE SUBSCRIPTION PLAN STEERS PAST KICKBACK PERILS
Ambulance companies that charge an annual subscription fee in lieu of collecting Medicare ... Read more
DME:
DIALYSIS SUPPLIERS SHOULD BRACE FOR CMS-382 SCRUTINY
Suppliers of home dialysis equipment should do their best to make sure their Medicare clie... Read more
DIALYSIS SUPPLIERS SHOULD BRACE FOR CMS-382 SCRUTINY
Suppliers of home dialysis equipment should do their best to make sure their Medicare clie... Read more
Coverage:
LOCAL COVERAGE POLICIES UNDER ATTACK
Confused by your Medicare contractor's local coverage policies? If the General Accounting ... Read more
LOCAL COVERAGE POLICIES UNDER ATTACK
Confused by your Medicare contractor's local coverage policies? If the General Accounting ... Read more
Fraud & Abuse:
SENTENCING APPEAL CAN'T SAVE SUPPLIER
The turning point in the campaign against health care fraud and abuse - the August 1996 ef... Read more
SENTENCING APPEAL CAN'T SAVE SUPPLIER
The turning point in the campaign against health care fraud and abuse - the August 1996 ef... Read more
PROGRAM MEMO ROUNDUP
Providers and contractors alike have been confused about certain elements of billing for d... Read more
Providers and contractors alike have been confused about certain elements of billing for d... Read more
BILL WATCH
The following Senate bills were introduced: S. 1113. A bill to amend title XVIII of the So... Read more
The following Senate bills were introduced: S. 1113. A bill to amend title XVIII of the So... Read more
REGISTER WATCH
The Joint Commission on Accreditation of Healthcare Organizations will serve as a nationa... Read more
The Joint Commission on Accreditation of Healthcare Organizations will serve as a nationa... Read more
Reimbursement:
TAX BILL: STATES GET HELP, BUT RURAL PROVIDERS MUST WAIT
States will get $20 billion in new federal money under the economic growth package passed ... Read more
TAX BILL: STATES GET HELP, BUT RURAL PROVIDERS MUST WAIT
States will get $20 billion in new federal money under the economic growth package passed ... Read more
Medicaid:
COMMERCE NAMES MEDICAID TASK FORCE
In search of Medicaid revisions to enhance the program and save cash, House Energy and Com... Read more
COMMERCE NAMES MEDICAID TASK FORCE
In search of Medicaid revisions to enhance the program and save cash, House Energy and Com... Read more
Medicare+Choice:
2004 PAYMENT RATES OFFER LITTLE HELP TO STRUGGLING M+COS
Will this be the straw that breaks Medicare+ Choice's back or the final insult that finall... Read more
2004 PAYMENT RATES OFFER LITTLE HELP TO STRUGGLING M+COS
Will this be the straw that breaks Medicare+ Choice's back or the final insult that finall... Read more
Medicare+Choice:
SOCIAL HMO PROGRAM COULD BE NEARING END
Medicare+Choice plans that have wanted to get in on Medicare's social HMO demonstration ma... Read more
SOCIAL HMO PROGRAM COULD BE NEARING END
Medicare+Choice plans that have wanted to get in on Medicare's social HMO demonstration ma... Read more
Pharmaceuticals:
DRUG REBATE EXPERIMENT WEATHERS HIGH COURT CHALLENGE
A state program that could point toward lower reimbursement for the nation's drugmakers ca... Read more
DRUG REBATE EXPERIMENT WEATHERS HIGH COURT CHALLENGE
A state program that could point toward lower reimbursement for the nation's drugmakers ca... Read more
Long-Term Care:
MEDICAID SHORTFALLS BODE ILL FOR NURSING HOMES' BOTTOM LINES
The sunset of Medicare add-on payments last year, looming therapy caps, proposed bad-debt ... Read more
MEDICAID SHORTFALLS BODE ILL FOR NURSING HOMES' BOTTOM LINES
The sunset of Medicare add-on payments last year, looming therapy caps, proposed bad-debt ... Read more
Labs:
WHAT TO EXPECT ON CLIA SURVEYS -THIS QUARTER
Good news for clinical labs: The Centers for Medicare & Medicaid Services is keeping s... Read more
WHAT TO EXPECT ON CLIA SURVEYS -THIS QUARTER
Good news for clinical labs: The Centers for Medicare & Medicaid Services is keeping s... Read more
Hospitals:
HOSPITALS MUST BEEF UP POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforc... Read more
HOSPITALS MUST BEEF UP POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforc... Read more
Hospitals:
RURAL HOSPITAL TRUMPS FEDS ON DSH
Rural facilities may be more likely to qualify for disproportionate share hospital payment... Read more
RURAL HOSPITAL TRUMPS FEDS ON DSH
Rural facilities may be more likely to qualify for disproportionate share hospital payment... Read more
Physicians:
SPECIALTY HOSPITALS FEEL THE HEAT
The compliance ground rules for physician-owned specialty hospitals could be in for a majo... Read more
SPECIALTY HOSPITALS FEEL THE HEAT
The compliance ground rules for physician-owned specialty hospitals could be in for a majo... Read more
Hospitals:
GETTING IT RIGHT ON OPPS MULTIPLE-PROCEDURE CLAIMS
A hospital's misunderstanding of outpatient prospective payment system billing rules has c... Read more
GETTING IT RIGHT ON OPPS MULTIPLE-PROCEDURE CLAIMS
A hospital's misunderstanding of outpatient prospective payment system billing rules has c... Read more
PROGRAM MEMO ROUNDUP
Health care providers who've been shortchanged on services involving mammography-related c... Read more
Health care providers who've been shortchanged on services involving mammography-related c... Read more
BILL WATCH
The following House bills were introduced: H.R. 2151. A bill to amend title XVIII of the S... Read more
The following House bills were introduced: H.R. 2151. A bill to amend title XVIII of the S... Read more
REGISTER WATCH
Arkansas and Michigan will each get another chance to argue for state plan amendments prev... Read more
Arkansas and Michigan will each get another chance to argue for state plan amendments prev... Read more
Budget:
HELP FOR STATES, RURAL AREAS IN SENATE BILL
The tax bill passed by the Senate May 15 includes $20 billion in fiscal relief for state a... Read more
HELP FOR STATES, RURAL AREAS IN SENATE BILL
The tax bill passed by the Senate May 15 includes $20 billion in fiscal relief for state a... Read more
Hospitals:
INPATIENT RULE LOWERS HIGH-TECH THRESHOLD
The Centers for Medicare and Medicaid Services says hospitals would get a 3.5-percent pay ... Read more
INPATIENT RULE LOWERS HIGH-TECH THRESHOLD
The Centers for Medicare and Medicaid Services says hospitals would get a 3.5-percent pay ... Read more
Medicare:
GAO: DEATH TO LOCAL COVERAGE PROCESS
The Centers for Medicare and Medicaid Services should strip Medicare contractors of their ... Read more
GAO: DEATH TO LOCAL COVERAGE PROCESS
The Centers for Medicare and Medicaid Services should strip Medicare contractors of their ... Read more
Rehab:
75-PERCENT RULE ENFORCEMENT LOOMS FOR IRFs
Rehab hospitals are in line for a 3.3-percent increase in their Medicare payments - but al... Read more
75-PERCENT RULE ENFORCEMENT LOOMS FOR IRFs
Rehab hospitals are in line for a 3.3-percent increase in their Medicare payments - but al... Read more
Medicaid:
MEDICAID REVISIONS STILL UP IN AIR ON HILL, AMONG GOVERNORS
The National Governors Association task force on Medicaid is a long way from consensus on ... Read more
MEDICAID REVISIONS STILL UP IN AIR ON HILL, AMONG GOVERNORS
The National Governors Association task force on Medicaid is a long way from consensus on ... Read more
Pharmaceuticals:
PRIVATE LABELING LEADS TO CRIMINAL FINES
The feds mean business when it comes to drug pricing improprieties. Case in point: A feder... Read more
PRIVATE LABELING LEADS TO CRIMINAL FINES
The feds mean business when it comes to drug pricing improprieties. Case in point: A feder... Read more
Hospitals:
19 DRGs ON PER-DIEM CHOPPING BLOCK
Hospitals have long grumbled over the Centers for Medicare & Medicaid Services' post-a... Read more
19 DRGs ON PER-DIEM CHOPPING BLOCK
Hospitals have long grumbled over the Centers for Medicare & Medicaid Services' post-a... Read more
Managed Care:
2004 M+C RATES LOW-BALL PLANS
Health plans aren't happy with the Centers for Medicare & Medicaid Services' 2004 Medi... Read more
2004 M+C RATES LOW-BALL PLANS
Health plans aren't happy with the Centers for Medicare & Medicaid Services' 2004 Medi... Read more
Overpayments:
CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS
Medicare contractors are boasting once again about the financial fallout from their medica... Read more
CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS
Medicare contractors are boasting once again about the financial fallout from their medica... Read more
Kickbacks:
DEDUCTIBLE DEALS LEGAL BETWEEN HOSPITALS, MEDIGAP PLANS
Medigap insurers may be able to work deals with hospitals for cut rates on inpatient deduc... Read more
DEDUCTIBLE DEALS LEGAL BETWEEN HOSPITALS, MEDIGAP PLANS
Medigap insurers may be able to work deals with hospitals for cut rates on inpatient deduc... Read more
Help With HIPAA:
4 STEPS FOR HANDLING PRIVACY COMPLAINTS WITHOUT GETTING BURNED
Even if you have a top-notch privacy compliance program in place, you're bound to be confr... Read more
4 STEPS FOR HANDLING PRIVACY COMPLAINTS WITHOUT GETTING BURNED
Even if you have a top-notch privacy compliance program in place, you're bound to be confr... Read more
HIPAA:
PART A PROVIDERS OPTIMISTIC ON HIPAA TRANSACTION STANDARDS
Medicare Part A providers are generally confident that they'll be ready for the Oct. 16 ze... Read more
PART A PROVIDERS OPTIMISTIC ON HIPAA TRANSACTION STANDARDS
Medicare Part A providers are generally confident that they'll be ready for the Oct. 16 ze... Read more
PROGRAM MEMO ROUNDUP
Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can tak... Read more
Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can tak... Read more
REGISTER WATCH
Skilled nursing facilities will see a 2.9 percent increase in their Medicare payments next... Read more
Skilled nursing facilities will see a 2.9 percent increase in their Medicare payments next... Read more
BILL WATCH
The following House bill was introduced: H.R. 2070. A bill to amend title XVIII of the Soc... Read more
The following House bill was introduced: H.R. 2070. A bill to amend title XVIII of the Soc... Read more
Outcomes:
HHAs USE HHQI TO SPREAD GOOD WORD ON HOME CARE
More than 1,200 home health agencies in eight states now have eleven patient outcomes post... Read more
HHAs USE HHQI TO SPREAD GOOD WORD ON HOME CARE
More than 1,200 home health agencies in eight states now have eleven patient outcomes post... Read more
Hospitals:
4 ORGAN ACQUISITION COST REPORTING PITFALLS
The complexities of Medicare reimbursement for organ transplant centers are all too clear ... Read more
4 ORGAN ACQUISITION COST REPORTING PITFALLS
The complexities of Medicare reimbursement for organ transplant centers are all too clear ... Read more
HIPAA:
5 HIPAA COMPLIANCE PRESSURE POINTS
The much-anticipated compliance deadline for the Health Insurance Portability and Accounta... Read more
5 HIPAA COMPLIANCE PRESSURE POINTS
The much-anticipated compliance deadline for the Health Insurance Portability and Accounta... Read more
Long-Term Care:
NURSING HOMES CAN'T STUMBLE ON DELEGATION COMPLICATIONS
Nursing home surveyors may soon be taking a closer look at the delegation of certain physi... Read more
NURSING HOMES CAN'T STUMBLE ON DELEGATION COMPLICATIONS
Nursing home surveyors may soon be taking a closer look at the delegation of certain physi... Read more
Managed Care:
THE DEVIL IS IN THE DETAILS WITH INSTITUTIONALIZED STATUS
Keeping up with the institutionalized status of Medicare beneficiaries enrolled in Medicar... Read more
THE DEVIL IS IN THE DETAILS WITH INSTITUTIONALIZED STATUS
Keeping up with the institutionalized status of Medicare beneficiaries enrolled in Medicar... Read more
EMTALA:
HOSPITAL PREVAILS IN DECADE-OLD EMTALA CASE
A ten-year-old patient anti-dumping case that worked its way all the way up to the U.S. Su... Read more
HOSPITAL PREVAILS IN DECADE-OLD EMTALA CASE
A ten-year-old patient anti-dumping case that worked its way all the way up to the U.S. Su... Read more
Settlements:
COMPUTER GLITCHES CAN COST YOU BIG
You don't have to profit from a billing snafu to have the feds come after you with a False... Read more
COMPUTER GLITCHES CAN COST YOU BIG
You don't have to profit from a billing snafu to have the feds come after you with a False... Read more
Reimbursement:
HHAs WIN BREATHING ROOM ON PEPS
Home health agencies have received another reprieve from the recoupments of tens of thousa... Read more
HHAs WIN BREATHING ROOM ON PEPS
Home health agencies have received another reprieve from the recoupments of tens of thousa... Read more
OASIS:
SENATOR OPPOSES OASIS SUSPENSION FOR PRIVATE PAY
Home health agencies will continue to collect Outcome Assessment and Information Set data ... Read more
SENATOR OPPOSES OASIS SUSPENSION FOR PRIVATE PAY
Home health agencies will continue to collect Outcome Assessment and Information Set data ... Read more
Therapy:
DOC-FURNISHED THERAPY NOT HHAS' RESPONSIBILITY
Starting this fall, physicians won't be knocking on home health agencies' doors asking for... Read more
DOC-FURNISHED THERAPY NOT HHAS' RESPONSIBILITY
Starting this fall, physicians won't be knocking on home health agencies' doors asking for... Read more
Rehab:
REHAB HOSPITALS IN LINE FOR 3.3 PERCENT INCREASE
Inpatient rehabilitation hospitals would get a 3.3 percent reimbursement increase under a ... Read more
REHAB HOSPITALS IN LINE FOR 3.3 PERCENT INCREASE
Inpatient rehabilitation hospitals would get a 3.3 percent reimbursement increase under a ... Read more
Whistleblowers:
WHISTLEBLOWER CFO TARGETS ALLEGED E&M SNAFUS
Here's one more reason to be sure your evaluation and management coding practices are up t... Read more
WHISTLEBLOWER CFO TARGETS ALLEGED E&M SNAFUS
Here's one more reason to be sure your evaluation and management coding practices are up t... Read more
SNFs:
CMS PROPOSES SNF PAYMENT INCREASE
The Centers for Medicare & Medicaid Services will propose increasing payments to skill... Read more
CMS PROPOSES SNF PAYMENT INCREASE
The Centers for Medicare & Medicaid Services will propose increasing payments to skill... Read more
HCA Watch:
DOJ APPROVES HCA SETTLEMENT
Nashville, TN-based HCA hospital giant came a step closer to putting an epochal fraud and ... Read more
DOJ APPROVES HCA SETTLEMENT
Nashville, TN-based HCA hospital giant came a step closer to putting an epochal fraud and ... Read more
PROGRAM MEMO ROUNDUP
Brace yourself, rehab providers. The Centers for Medicare & Medicaid Services is geari... Read more
Brace yourself, rehab providers. The Centers for Medicare & Medicaid Services is geari... Read more
Physician Payment:
MEDICARE, PRIVATE-PAY RATES CREEP CLOSER TOGETHER
Is Medicare's influence on private payers what's really bugging docs? Despite threats from... Read more
MEDICARE, PRIVATE-PAY RATES CREEP CLOSER TOGETHER
Is Medicare's influence on private payers what's really bugging docs? Despite threats from... Read more
Compliance:
DOCS FACE THE MUSIC IN OIG PHARMA GUIDANCE
Drugmakers and health care providers alike got an important lesson in Medicare compliance ... Read more
DOCS FACE THE MUSIC IN OIG PHARMA GUIDANCE
Drugmakers and health care providers alike got an important lesson in Medicare compliance ... Read more
Home Health:
EXTRA, EXTRA - READ ALL ABOUT HHA QUALITY
Home health agencies, like nursing homes, are now making public reckonings of the quality ... Read more
EXTRA, EXTRA - READ ALL ABOUT HHA QUALITY
Home health agencies, like nursing homes, are now making public reckonings of the quality ... Read more
Ambulance Services:
QUICK TEST FOR MEASURING UP AMBULANCE COPAY KICKBACK RISKS
Municipally-owned ambulance services can put in place "insurance only" billing arrangement... Read more
QUICK TEST FOR MEASURING UP AMBULANCE COPAY KICKBACK RISKS
Municipally-owned ambulance services can put in place "insurance only" billing arrangement... Read more
Long-Term Care:
NURSING HOME DEFICIENCIES ON THE RISE
If you're a long-term care facility bewildered by the survey process, you're not alone. Th... Read more
NURSING HOME DEFICIENCIES ON THE RISE
If you're a long-term care facility bewildered by the survey process, you're not alone. Th... Read more
HealthSouth Watch:
FEDS FIVE-FOR-FIVE ON HEALTHSOUTH CFOs
The high-profile accounting fraud probe of troubled rehab company HealthSouth Corp. contin... Read more
FEDS FIVE-FOR-FIVE ON HEALTHSOUTH CFOs
The high-profile accounting fraud probe of troubled rehab company HealthSouth Corp. contin... Read more
Medicare:
BAD DEBT PROPOSAL BAD NEWS, ASSOCIATIONS SAY
A trio of health care provider advocacy groups is beseeching the Centers for Medicare and ... Read more
BAD DEBT PROPOSAL BAD NEWS, ASSOCIATIONS SAY
A trio of health care provider advocacy groups is beseeching the Centers for Medicare and ... Read more
Reimbursement:
PEP ADJUSTMENTS BACK ON - NO, REALLY THIS TIME
It looks like the Centers for Medicare & Medicaid Services plans to gradually nibble a... Read more
PEP ADJUSTMENTS BACK ON - NO, REALLY THIS TIME
It looks like the Centers for Medicare & Medicaid Services plans to gradually nibble a... Read more
Physicians:
PHYSICIANS STILL FACE TEACHING HOSPITAL COMPLIANCE WOES
Physician presence rules in the teaching hospital setting are among the oldest compliance ... Read more
PHYSICIANS STILL FACE TEACHING HOSPITAL COMPLIANCE WOES
Physician presence rules in the teaching hospital setting are among the oldest compliance ... Read more
Business Arrangements:
5 RED FLAGS FOR DRUGMAKER-DOC BUSINESS ARRANGEMENTS
Physicians and pharmaceutical companies are in the kickback enforcement crosshairs, as the... Read more
5 RED FLAGS FOR DRUGMAKER-DOC BUSINESS ARRANGEMENTS
Physicians and pharmaceutical companies are in the kickback enforcement crosshairs, as the... Read more
Laboratories:
LAB UNBUNDLING SCRUTINY NEVER DIES
Laboratory claims have long been a chief target of fraud enforcement agencies, and the scr... Read more
LAB UNBUNDLING SCRUTINY NEVER DIES
Laboratory claims have long been a chief target of fraud enforcement agencies, and the scr... Read more
PROGRAM MEMO ROUNDUP
The interest rate for Medicare overpayments and underpayments went up April 28, rising fro... Read more
The interest rate for Medicare overpayments and underpayments went up April 28, rising fro... Read more
REGISTER WATCH
State and federal health officials would love to know what works best in Medicaid and SCHI... Read more
State and federal health officials would love to know what works best in Medicaid and SCHI... Read more
BILL WATCH
The following House bills were introduced: H.R. 1853. A bill to amend title XVIII of the S... Read more
The following House bills were introduced: H.R. 1853. A bill to amend title XVIII of the S... Read more
Home Health:
'HOME HEALTH COMPARE' SET TO GO LIVE, FLAWS AND ALL
Widespread errors with administrative data on the soon-to-be-unveiled Home Health Compare ... Read more
'HOME HEALTH COMPARE' SET TO GO LIVE, FLAWS AND ALL
Widespread errors with administrative data on the soon-to-be-unveiled Home Health Compare ... Read more
Medicare Pass-Through:
ANEMIA DRUG DISPUTE FILLS CMS MAILBAG
Both Republicans and Democrats are criticizing the way the Centers for Medicare and Medica... Read more
ANEMIA DRUG DISPUTE FILLS CMS MAILBAG
Both Republicans and Democrats are criticizing the way the Centers for Medicare and Medica... Read more
Medicaid Drugs:
LEGISLATIVE OFFICE URGES FLORIDA TO DUMP PFIZER MEDICAID PROGRAM
Saying it hasn't seen solid evidence of significant savings produced by disease-management... Read more
LEGISLATIVE OFFICE URGES FLORIDA TO DUMP PFIZER MEDICAID PROGRAM
Saying it hasn't seen solid evidence of significant savings produced by disease-management... Read more
Business Arrangements:
EXPANDING SERVICES THROUGH A JV? 5 RED FLAGS IN OIG'S SCOPES
If your expansion plans have led you to create a new business that subcontracts out most o... Read more
EXPANDING SERVICES THROUGH A JV? 5 RED FLAGS IN OIG'S SCOPES
If your expansion plans have led you to create a new business that subcontracts out most o... Read more
Physicians:
FRAUD HUNT SPOOKS DOCS INTO DOWNCODING
Haunted by late-night worries about being targeted in a Medicare fraud investigation? If y... Read more
FRAUD HUNT SPOOKS DOCS INTO DOWNCODING
Haunted by late-night worries about being targeted in a Medicare fraud investigation? If y... Read more
HCA Watch:
GRASSLEY CONTINUES SCRUTINY OF HCA SETTLEMENT
Senate Finance Committee chair Chuck Grassley (R-IA) has written a fourth letter regarding... Read more
GRASSLEY CONTINUES SCRUTINY OF HCA SETTLEMENT
Senate Finance Committee chair Chuck Grassley (R-IA) has written a fourth letter regarding... Read more
HealthSouth Watch:
REHAB GIANT FACES CONGRESSIONAL PROBE
Imploding rehab giant HealthSouth Corp.'s woes deepened April 22, with a Congressional pan... Read more
REHAB GIANT FACES CONGRESSIONAL PROBE
Imploding rehab giant HealthSouth Corp.'s woes deepened April 22, with a Congressional pan... Read more
Coverage:
WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES
Health care providers will soon be able to bill Medicare for positron emission tomography ... Read more
WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES
Health care providers will soon be able to bill Medicare for positron emission tomography ... Read more
Self-Referral:
PROVIDERS GET BREATHING ROOM ON 'SET-IN-ADVANCE' RULE
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare Jul... Read more
PROVIDERS GET BREATHING ROOM ON 'SET-IN-ADVANCE' RULE
Teaching hospitals and medical foundations bracing for a potential paperwork nightmare Jul... Read more
Hospitals:
NEW RULES HIT HOME FOR HOSPITAL SURVEYS
With new hospital quality rules in effect for Medicare, surveyors will be taking a differe... Read more
NEW RULES HIT HOME FOR HOSPITAL SURVEYS
With new hospital quality rules in effect for Medicare, surveyors will be taking a differe... Read more
Medicare:
PROVIDERS, SUPPLIERS FACE NEW ENROLLMENT STANDARDS
A wider range of Medicare providers could be subject to site visits to verify their enroll... Read more
PROVIDERS, SUPPLIERS FACE NEW ENROLLMENT STANDARDS
A wider range of Medicare providers could be subject to site visits to verify their enroll... Read more
Fraud & Abuse:
PLANS, AGENCIES GET PRICE CUT ON HIPDB
Health plans and government agencies soon will get a price cut when they run a provider qu... Read more
PLANS, AGENCIES GET PRICE CUT ON HIPDB
Health plans and government agencies soon will get a price cut when they run a provider qu... Read more
Fraud & Abuse:
DRUGMAKERS' FRAUD SETTLEMENTS BIGGEST EVER FOR MEDICAID
Pharmaceutical manufacturers Bayer AG and GlaxoSmithKline will pay the federal government,... Read more
DRUGMAKERS' FRAUD SETTLEMENTS BIGGEST EVER FOR MEDICAID
Pharmaceutical manufacturers Bayer AG and GlaxoSmithKline will pay the federal government,... Read more
PROGRAM MEMO ROUNDUP
Hospitals that "self attest" their provider-based entities could save themselves a bundle ... Read more
Hospitals that "self attest" their provider-based entities could save themselves a bundle ... Read more
REGISTER WATCH
In its last-Friday-of-the-month flurry of regulations, the Centers for Medicare & Medi... Read more
In its last-Friday-of-the-month flurry of regulations, the Centers for Medicare & Medi... Read more
Medicare Drug Benefit:
CONGRESS DESPERATELY SEEKING WAYS TO RETOOL DRUG BILLS
With the White House's 2003 Medicare prescription-drug proposal now in the mix, members of... Read more
CONGRESS DESPERATELY SEEKING WAYS TO RETOOL DRUG BILLS
With the White House's 2003 Medicare prescription-drug proposal now in the mix, members of... Read more
Medicaid:
NGA MEDICAID PANEL MULLING MORE THAN WHITE HOUSE PLAN
The ten-member governors' task force convened by the National Governors Association hopes ... Read more
NGA MEDICAID PANEL MULLING MORE THAN WHITE HOUSE PLAN
The ten-member governors' task force convened by the National Governors Association hopes ... Read more
Medicare Reform:
HEALTH PLANS FIGHTING NEGATIVE PERCEPTIONS IN REFORM BATTLE
Health plans hoping to see a larger population of Medicare beneficiaries move into private... Read more
HEALTH PLANS FIGHTING NEGATIVE PERCEPTIONS IN REFORM BATTLE
Health plans hoping to see a larger population of Medicare beneficiaries move into private... Read more
Dual Eligibles:
COULD STATE CONCERNS BE KEY TO FATE OF MEDICARE Rx?
High on states' wish list for Congress is legislation to shift Medicaid costs for benefici... Read more
COULD STATE CONCERNS BE KEY TO FATE OF MEDICARE Rx?
High on states' wish list for Congress is legislation to shift Medicaid costs for benefici... Read more
Litigation:
GALLUP SUES SCULLY OVER ALLEGED BULLYING
The Gallup Organization polling firm has filed suit against Centers for Medicare & Med... Read more
GALLUP SUES SCULLY OVER ALLEGED BULLYING
The Gallup Organization polling firm has filed suit against Centers for Medicare & Med... Read more
Hospitals:
HOSPITAL-PHYSICIAN BUSINESS DEALS UNDER SCRUTINY
Heads up hospitals and physicians: The feds are looking ever more closely at medical group... Read more
HOSPITAL-PHYSICIAN BUSINESS DEALS UNDER SCRUTINY
Heads up hospitals and physicians: The feds are looking ever more closely at medical group... Read more
Reimbursement:
HOSPITALS BEMOAN OUTLIER CHANGES
Hospitals should brace themselves for potential reimbursement shortfalls under the Centers... Read more
HOSPITALS BEMOAN OUTLIER CHANGES
Hospitals should brace themselves for potential reimbursement shortfalls under the Centers... Read more
Physicians:
PHYSICIANS CAN EARN CMEs THROUGH QIOs
Physicians have one more incentive to get involved with the Centers for Medicare & Med... Read more
PHYSICIANS CAN EARN CMEs THROUGH QIOs
Physicians have one more incentive to get involved with the Centers for Medicare & Med... Read more
Medicare:
OIG SLAMS CODING SEMINAR COMPANY
Have you been duped by coding and billing education companies that tout non-existent forma... Read more
OIG SLAMS CODING SEMINAR COMPANY
Have you been duped by coding and billing education companies that tout non-existent forma... Read more
Fraud & Abuse:
YOUR PATIENTS ARE WATCHING YOU
Your Medicare patients are more likely than ever to have been trained on ferreting out fra... Read more
YOUR PATIENTS ARE WATCHING YOU
Your Medicare patients are more likely than ever to have been trained on ferreting out fra... Read more
Business Arrangements:
PER-PATIENT FEE STRUCTURES RAISE COMPLIANCE RED FLAGS
If you're about to ink a business deal with another health care provider that involves a "... Read more
PER-PATIENT FEE STRUCTURES RAISE COMPLIANCE RED FLAGS
If you're about to ink a business deal with another health care provider that involves a "... Read more
Hospitals:
OUTLIER BLUNDERS GO BOTH WAYS
Hospitals face ever-mounting attention on Medicare outlier payments - and are bracing for ... Read more
OUTLIER BLUNDERS GO BOTH WAYS
Hospitals face ever-mounting attention on Medicare outlier payments - and are bracing for ... Read more
Overpayments:
EPOGEN, Rx CHARGES STAND OUT IN OUTPATIENT PAYMENT REVIEW
Providers of outpatient services should take note that their claims are under scrutiny by ... Read more
EPOGEN, Rx CHARGES STAND OUT IN OUTPATIENT PAYMENT REVIEW
Providers of outpatient services should take note that their claims are under scrutiny by ... Read more
Long-Term Care:
SNFs FACE ELIGIBILITY SCRUTINY
Skilled nursing facilities across the country could soon be asked to hand back Medicare do... Read more
SNFs FACE ELIGIBILITY SCRUTINY
Skilled nursing facilities across the country could soon be asked to hand back Medicare do... Read more
Coverage:
MRA COVERAGE EXPANDS
Health care providers will soon have more opportunities to collect Medicare reimbursement ... Read more
MRA COVERAGE EXPANDS
Health care providers will soon have more opportunities to collect Medicare reimbursement ... Read more
HIPAA:
EXPECT THE EXPECTED IN HIPAA ENFORCEMENT
Curious about what it will be like if you get slapped with allegations that you ran afoul ... Read more
EXPECT THE EXPECTED IN HIPAA ENFORCEMENT
Curious about what it will be like if you get slapped with allegations that you ran afoul ... Read more
OASIS:
HHAs MIGHT HAVE TO PLAY 'DOCTOR, MAY I?' FOR CODING
Everyone knows it's the physician and not the home health agency that officially diagnoses... Read more
HHAs MIGHT HAVE TO PLAY 'DOCTOR, MAY I?' FOR CODING
Everyone knows it's the physician and not the home health agency that officially diagnoses... Read more
Reimbursement:
CMS SHOOTS DOWN PRRB REVERSAL OF PTs' SALARY ADJUSTMENTS
Despite numerous Provider Reimbursement Review Board and federal court decisions decreeing... Read more
CMS SHOOTS DOWN PRRB REVERSAL OF PTs' SALARY ADJUSTMENTS
Despite numerous Provider Reimbursement Review Board and federal court decisions decreeing... Read more
Hospitals:
NEW RULES HIT HOME FOR HOSPITAL SURVEYS
With new hospital quality rules in effect for Medicare, surveyors will be taking a differe... Read more
NEW RULES HIT HOME FOR HOSPITAL SURVEYS
With new hospital quality rules in effect for Medicare, surveyors will be taking a differe... Read more
Coverage:
WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES
Health care providers will soon be able to bill Medicare for positron emission tomography ... Read more
WINS, LOSSES AND TIES IN MEDICARE PET SCAN POLICIES
Health care providers will soon be able to bill Medicare for positron emission tomography ... Read more
PROGRAM MEMO ROUNDUP
Durable medical equipment suppliers have a host of new "K" codes to get familiar with, tha... Read more
Durable medical equipment suppliers have a host of new "K" codes to get familiar with, tha... Read more
REGISTER WATCH
The Centers for Medicare & Medicaid Services' tardiness in implementing a national fee... Read more
The Centers for Medicare & Medicaid Services' tardiness in implementing a national fee... Read more
BILL WATCH
The following House bills were introduced: H.R. 1784. A bill to amend title XVIII of the S... Read more
The following House bills were introduced: H.R. 1784. A bill to amend title XVIII of the S... Read more
WHO'S WHO IN MEDICARE
Centers for Medicare & Medicaid Services Deputy Administrator Ruben King-Shaw has lef... Read more
Centers for Medicare & Medicaid Services Deputy Administrator Ruben King-Shaw has lef... Read more
Legislation:
MEDICAID CUTS HANG IN THE BALANCE
The House and Senate are duking it out over $93 billion in Medicaid cuts, and providers co... Read more
MEDICAID CUTS HANG IN THE BALANCE
The House and Senate are duking it out over $93 billion in Medicaid cuts, and providers co... Read more
Quality Improvement:
NEWSPAPER ADS COMPARING HHA OUTCOMES WEEKS AWAY
The Centers for Medicare & Medicaid Services will trumpet home health agency patient o... Read more
NEWSPAPER ADS COMPARING HHA OUTCOMES WEEKS AWAY
The Centers for Medicare & Medicaid Services will trumpet home health agency patient o... Read more
Pharmaceuticals:
COURT OKS MICHIGAN MEDICAID RX PROGRAM
Michigan may go forward with its effort to obtain deep discounts from prescription-drug ma... Read more
COURT OKS MICHIGAN MEDICAID RX PROGRAM
Michigan may go forward with its effort to obtain deep discounts from prescription-drug ma... Read more
Medicare+Choice:
MOST POPULAR M+C PLANS TO GET TWO PERCENT RAISE
In 2004, managed care plans serving the majority of Medicare+Choice beneficiaries will aga... Read more
MOST POPULAR M+C PLANS TO GET TWO PERCENT RAISE
In 2004, managed care plans serving the majority of Medicare+Choice beneficiaries will aga... Read more
Compliance:
HEALTH CARE DIRECTORS MUST SPEAK UP ON COMPLIANCE
As the Enron fiasco continues to play out and the HealthSouth debacle puts the corporate f... Read more
HEALTH CARE DIRECTORS MUST SPEAK UP ON COMPLIANCE
As the Enron fiasco continues to play out and the HealthSouth debacle puts the corporate f... Read more
Medicare:
MEDICARE REGULATORY REFORM MOVES FORWARD, BUT HALTINGLY
It's nice to know that even in the House Ways and Means Committee, occasionally a bill com... Read more
MEDICARE REGULATORY REFORM MOVES FORWARD, BUT HALTINGLY
It's nice to know that even in the House Ways and Means Committee, occasionally a bill com... Read more
Self-Referral:
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with physi... Read more
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with physi... Read more
Quality of Care:
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very w... Read more
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very w... Read more
Physicians:
STAFFING COMPANIES IN LINE FOR STEPPED UP SCRUTINY
Staffing companies that contract with physicians to staff emergency rooms and other hospit... Read more
STAFFING COMPANIES IN LINE FOR STEPPED UP SCRUTINY
Staffing companies that contract with physicians to staff emergency rooms and other hospit... Read more
HIPAA:
PROVIDERS ADOPT 'JUST-IN-TIME' APPROACH TO HIPAA COMPLIANCE
Have you deferred a good chunk of your Health Insurance Portability and Accountability Act... Read more
PROVIDERS ADOPT 'JUST-IN-TIME' APPROACH TO HIPAA COMPLIANCE
Have you deferred a good chunk of your Health Insurance Portability and Accountability Act... Read more
Medicaid:
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils t... Read more
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils t... Read more
Reimbursement:
NEW APPROACHES TO NEW TECH PAYMENTS
Health care providers that deal extensively with new and emerging technologies may soon se... Read more
NEW APPROACHES TO NEW TECH PAYMENTS
Health care providers that deal extensively with new and emerging technologies may soon se... Read more
Medicaid:
AUDIOLOGISTS FACE NEW RULES FOR MEDICAID
Audiologists would have to meet a new set of requirements to provide services - including ... Read more
AUDIOLOGISTS FACE NEW RULES FOR MEDICAID
Audiologists would have to meet a new set of requirements to provide services - including ... Read more
Medicare+Choice:
FINAL M+C APPEAL RULE EASES ADVANCE NOTICE REQUIREMENT
Medicare+Choice organizations will have to notify enrollees two days prior to terminating ... Read more
FINAL M+C APPEAL RULE EASES ADVANCE NOTICE REQUIREMENT
Medicare+Choice organizations will have to notify enrollees two days prior to terminating ... Read more
PROGRAM MEMO ROUNDUP
Health care providers that bill Medicare for Part B mental health services should take spe... Read more
Health care providers that bill Medicare for Part B mental health services should take spe... Read more
BILL WATCH
The following House bills were introduced: H.R. 1539. A bill to amend title XVIII of the S... Read more
The following House bills were introduced: H.R. 1539. A bill to amend title XVIII of the S... Read more
Budget:
SENATORS, PROVIDERS ARGUE AGAINST MEDICAID CUTS
Seventy-nine senators, led by Finance Committee chair Chuck Grassley (R-IA) and senior pan... Read more
SENATORS, PROVIDERS ARGUE AGAINST MEDICAID CUTS
Seventy-nine senators, led by Finance Committee chair Chuck Grassley (R-IA) and senior pan... Read more
Reimbursement:
ROCKY REIMBURSEMENT ROAD AHEAD FOR PHYSICIANS, HOSPITALS
Physicians aren't getting much opportunity to celebrate this year's Medicare reimbursement... Read more
ROCKY REIMBURSEMENT ROAD AHEAD FOR PHYSICIANS, HOSPITALS
Physicians aren't getting much opportunity to celebrate this year's Medicare reimbursement... Read more
HIPAA:
OCR OPENS DOOR TO PRIVACY COMPLAINTS
Health care organizations, take note: The HHS Office of Civil Rights March 20 laid out the... Read more
OCR OPENS DOOR TO PRIVACY COMPLAINTS
Health care organizations, take note: The HHS Office of Civil Rights March 20 laid out the... Read more
Home Health:
HOME HEALTH INDUSTRY GRAPPLES WITH SPENDING GROWTH FIGURES
Home care providers' efforts to secure reimbursement relief from Congress may have taken a... Read more
HOME HEALTH INDUSTRY GRAPPLES WITH SPENDING GROWTH FIGURES
Home care providers' efforts to secure reimbursement relief from Congress may have taken a... Read more
DME:
FEDS MEAN BUSINESS ON TELEMARKETING RESTRICTIONS
Federal regulators are walking their talk when it comes to enforcing rules prohibiting dur... Read more
FEDS MEAN BUSINESS ON TELEMARKETING RESTRICTIONS
Federal regulators are walking their talk when it comes to enforcing rules prohibiting dur... Read more
Ambulances:
MEDICAL NECESSITY KEY IN AMBULANCE COMPLIANCE GUIDANCE
As health care fraud enforcement heats up for ambulance suppliers - especially at the stat... Read more
MEDICAL NECESSITY KEY IN AMBULANCE COMPLIANCE GUIDANCE
As health care fraud enforcement heats up for ambulance suppliers - especially at the stat... Read more
Hospitals:
WHISTLEBLOWER WINDFALL IN RECORD-BREAKING STARK CASE
A hospital employee who blew the whistle on alleged stark violations in a hospital-physici... Read more
WHISTLEBLOWER WINDFALL IN RECORD-BREAKING STARK CASE
A hospital employee who blew the whistle on alleged stark violations in a hospital-physici... Read more
Hospitals:
CHARITABLE PROGRAMS CAN EVADE KICKBACK PERILS
Hospitals with a charitable mission have to take care that their efforts to help indigent ... Read more
CHARITABLE PROGRAMS CAN EVADE KICKBACK PERILS
Hospitals with a charitable mission have to take care that their efforts to help indigent ... Read more
DME:
DON'T BE TOO FORWARD WITH YOUR ADVANCES, OIG TELLS DMERCs
The check may be in the mail - but you might never see it anyway. A mix-up with the addres... Read more
DON'T BE TOO FORWARD WITH YOUR ADVANCES, OIG TELLS DMERCs
The check may be in the mail - but you might never see it anyway. A mix-up with the addres... Read more
Fraud & Abuse:
PAY A FINE, APPEAR ONLINE
Clash with the HHS Office of Inspector General and you could find yourself touted on the a... Read more
PAY A FINE, APPEAR ONLINE
Clash with the HHS Office of Inspector General and you could find yourself touted on the a... Read more
Managed Care:
DUAL-ELIGIBLE BLUNDERS COMPLICATE MCO PAYMENTS
Florida managed Medicare companies were the lucky beneficiaries of a costly error by the F... Read more
DUAL-ELIGIBLE BLUNDERS COMPLICATE MCO PAYMENTS
Florida managed Medicare companies were the lucky beneficiaries of a costly error by the F... Read more
ASCs:
ASC RATESETTING STILL STALLED
Ambulatory surgical centers now have an updated list of the procedures Medicare has approv... Read more
ASC RATESETTING STILL STALLED
Ambulatory surgical centers now have an updated list of the procedures Medicare has approv... Read more
Medicaid:
SUPREME COURT WILL HEAR TEXAS MEDICAID CASE
Did Texas waive its immunity under the federal constitution's 11th Amendment by entering i... Read more
SUPREME COURT WILL HEAR TEXAS MEDICAID CASE
Did Texas waive its immunity under the federal constitution's 11th Amendment by entering i... Read more
BILL WATCH
The following House bill was introduced: H.R. 1422. A bill to amend title XVIII of the Soc... Read more
The following House bill was introduced: H.R. 1422. A bill to amend title XVIII of the Soc... Read more
REGISTER WATCH
Haven't been keeping up with the Federal Register? Missing a back issue? Here's your chanc... Read more
Haven't been keeping up with the Federal Register? Missing a back issue? Here's your chanc... Read more
PROGRAM MEMO ROUNDUP
Medicare carriers will continue using existing policies on using statistical sampling to e... Read more
Medicare carriers will continue using existing policies on using statistical sampling to e... Read more
Medicare:
MEDICARE TAB KEEPS GROWING, ALONG WITH PLANS FOR REFORM
The Medicare Part A Hospital Insurance Trust Fund will become insolvent in 2026, four ye... Read more
MEDICARE TAB KEEPS GROWING, ALONG WITH PLANS FOR REFORM
The Medicare Part A Hospital Insurance Trust Fund will become insolvent in 2026, four ye... Read more
Regional Payment Variation:
MEDPAC CHURNS OUT NEW ANALYSIS OF USE, SPENDING DATA
Data being developed for the Medicare Payment Advisory Commission’s June report cl... Read more
MEDPAC CHURNS OUT NEW ANALYSIS OF USE, SPENDING DATA
Data being developed for the Medicare Payment Advisory Commission’s June report cl... Read more
Spending:
HOUSE GIVES MEDICARE REPRIEVE, MEDICAID STILL ON CHOPPING BLOCK
The budget resolution approved, 215-212, by the House March 20 spares Medicare from cuts... Read more
HOUSE GIVES MEDICARE REPRIEVE, MEDICAID STILL ON CHOPPING BLOCK
The budget resolution approved, 215-212, by the House March 20 spares Medicare from cuts... Read more
Reimbursement:
FINANCIAL GOING TOUGH FOR DOCS, HOSPITALS
Physicians aren’t getting much opportunity to celebrate this year’s Medicare... Read more
FINANCIAL GOING TOUGH FOR DOCS, HOSPITALS
Physicians aren’t getting much opportunity to celebrate this year’s Medicare... Read more
Regulation:
HEALTH SUBPANEL APPROVES REG REFORM
It only seems like it’s once a month that the House votes to streamline Medicare r... Read more
HEALTH SUBPANEL APPROVES REG REFORM
It only seems like it’s once a month that the House votes to streamline Medicare r... Read more
Medicare+Choice:
BUSH MEDICARE RX REFORM WOULD BENEFIT MCOS
Managed care is the base upon which President Bush wants to build a new Medicare. That... Read more
BUSH MEDICARE RX REFORM WOULD BENEFIT MCOS
Managed care is the base upon which President Bush wants to build a new Medicare. That... Read more
Medicare+Choice:
BILL OFFERS GOOD NEWS TO M+COS IN SUBURBIA
Medicare+Choice organizations would get a much-needed payment boost under bipartisan leg... Read more
BILL OFFERS GOOD NEWS TO M+COS IN SUBURBIA
Medicare+Choice organizations would get a much-needed payment boost under bipartisan leg... Read more
Medicaid:
OIG, LONE STAR STATE SPAR OVER DSH
Texas hospitals that serve significant numbers of low-income and uninsured patients woul... Read more
OIG, LONE STAR STATE SPAR OVER DSH
Texas hospitals that serve significant numbers of low-income and uninsured patients woul... Read more
Medicaid:
BAY STATE ACES HOSPITAL PAYMENT REVIEW
Massachusetts’ health department has its ducks in a row when it comes to restricti... Read more
BAY STATE ACES HOSPITAL PAYMENT REVIEW
Massachusetts’ health department has its ducks in a row when it comes to restricti... Read more
Fraud & Abuse:
MANY WATCHDOGS EYE HEALTH CARE FRAUD
Health care providers that think the feds are going to get lax about the fight against h... Read more
MANY WATCHDOGS EYE HEALTH CARE FRAUD
Health care providers that think the feds are going to get lax about the fight against h... Read more
HIPAA:
URAC STEPS INTO HIPAA SECURITY ACCREDITATION
Health care providers that want an outside seal of approval for their Health Insurance P... Read more
URAC STEPS INTO HIPAA SECURITY ACCREDITATION
Health care providers that want an outside seal of approval for their Health Insurance P... Read more
HIPAA:
HIPAA QUESTIONS ANSWERED
Nursing homes wondering whether the Health Insurance Portability and Accountability Act&... Read more
HIPAA QUESTIONS ANSWERED
Nursing homes wondering whether the Health Insurance Portability and Accountability Act&... Read more
PROGRAM MEMO ROUNDUP
Hospitals subject to the outpatient prospective payment system will be getting some new ... Read more
Hospitals subject to the outpatient prospective payment system will be getting some new ... Read more
REGISTER WATCH
Have any bright ideas on how to recruit and retain workers serving Medicaid recipients w... Read more
Have any bright ideas on how to recruit and retain workers serving Medicaid recipients w... Read more
BILL WATCH
The following House bills were introduced: H.R. 1301. A bill to amend title XVIII of t... Read more
The following House bills were introduced: H.R. 1301. A bill to amend title XVIII of t... Read more
Reimbursement:
MEDICARE, MEDICAID FUNDING SLASHED IN HOUSE BUDGET DEAL
Members of Congress, including many Democrats, are lending a sympathetic ear to governor... Read more
MEDICARE, MEDICAID FUNDING SLASHED IN HOUSE BUDGET DEAL
Members of Congress, including many Democrats, are lending a sympathetic ear to governor... Read more
Reimbursement:
CONGRESS SEEKS TO PROTECT LOCAL PROVIDERS
Particularly on the Republican side, members of Congress often call for tighter controls... Read more
CONGRESS SEEKS TO PROTECT LOCAL PROVIDERS
Particularly on the Republican side, members of Congress often call for tighter controls... Read more
Medicaid:
CONGRESS FACES GRIM CHOICES OVER MEDICAID CUTS
To cut over $90 billion from federal Medicaid spending growth over ten years, Congress h... Read more
CONGRESS FACES GRIM CHOICES OVER MEDICAID CUTS
To cut over $90 billion from federal Medicaid spending growth over ten years, Congress h... Read more
Patient Safety:
HOUSE BILL SEEKS QUALITY IMPROVEMENT
The House March 12 overwhelmingly passed patient safety legislation virtually identical ... Read more
HOUSE BILL SEEKS QUALITY IMPROVEMENT
The House March 12 overwhelmingly passed patient safety legislation virtually identical ... Read more
Health-Care Spending:
SENATE BUDGET PANEL WOULD LET STATES KEEP SCHIP FUNDS
Senate leaders want to put their stamp on Medicare and Medicaid spending. In his cha... Read more
SENATE BUDGET PANEL WOULD LET STATES KEEP SCHIP FUNDS
Senate leaders want to put their stamp on Medicare and Medicaid spending. In his cha... Read more
Pharmaceuticals:
NO RELIEF ON AWP SCRUTINY
Pharmaceutical companies across the country are coming increasingly under the gun as sta... Read more
NO RELIEF ON AWP SCRUTINY
Pharmaceutical companies across the country are coming increasingly under the gun as sta... Read more
False Claims Act:
BELL TOLLS, WHISTLE BLOWS FOR CITY- AND COUNTY-RUN FACILITIES
The harsh penalties of the powerful False Claims Act can be levied against a wider range... Read more
BELL TOLLS, WHISTLE BLOWS FOR CITY- AND COUNTY-RUN FACILITIES
The harsh penalties of the powerful False Claims Act can be levied against a wider range... Read more
Hospitals:
WATCH OUT FOR DISCHARGE STATUS CODING
Hospital compliance officers should make sure their staff knows the ropes when it comes ... Read more
WATCH OUT FOR DISCHARGE STATUS CODING
Hospital compliance officers should make sure their staff knows the ropes when it comes ... Read more
Fraud & Abuse:
THIS IS HEALTH CARE FRAUD ON DRUGS
Think the federal government isn’t still taking health care fraud and abuse seriou... Read more
THIS IS HEALTH CARE FRAUD ON DRUGS
Think the federal government isn’t still taking health care fraud and abuse seriou... Read more
Quality of Care:
PHYSICIANS POISED FOR MORE CMS SCRUTINY
Physicians might already feel that they’re being monitored more than enough, but t... Read more
PHYSICIANS POISED FOR MORE CMS SCRUTINY
Physicians might already feel that they’re being monitored more than enough, but t... Read more
PROGRAM MEMO ROUNDUP
Independent therapists and durable medical equipment suppliers will face stepped-up scru... Read more
Independent therapists and durable medical equipment suppliers will face stepped-up scru... Read more
BILL WATCH:
BILL WATCH:
The following House bills were introduced: H.R. 1182. A bill to amend title XVIII of t... Read more
BILL WATCH:
The following House bills were introduced: H.R. 1182. A bill to amend title XVIII of t... Read more
REGISTER WATCH
In a comparatively slow week for the Centers for Medicare & Medicaid Services, the a... Read more
In a comparatively slow week for the Centers for Medicare & Medicaid Services, the a... Read more
Pharmaceuticals:
MEDICARE FFS RX BENEFIT PROPOSAL UNVEILED
Those who chose to stay in traditional feefor- service Medicare would get only a limited... Read more
MEDICARE FFS RX BENEFIT PROPOSAL UNVEILED
Those who chose to stay in traditional feefor- service Medicare would get only a limited... Read more
Medicare Private Plans:
BUSH WANTS FEHBP ANALOGUE, COMPETITIVE MEDICARE+CHOICE
Beneficiaries willing to leave traditional Medicare and join a private plan would have t... Read more
BUSH WANTS FEHBP ANALOGUE, COMPETITIVE MEDICARE+CHOICE
Beneficiaries willing to leave traditional Medicare and join a private plan would have t... Read more
DME:
OIG HANGS UP ON DME TELEMARKETERS
Irked by telemarketing calls? So is the HHS Office of Inspector General — and if... Read more
OIG HANGS UP ON DME TELEMARKETERS
Irked by telemarketing calls? So is the HHS Office of Inspector General — and if... Read more
HHS Inspector General:
UNDER CLOSE INSPECTION, INSPECTOR GENERAL QUITS
As investigation into her conduct of the office of Health and Human Services Inspector G... Read more
UNDER CLOSE INSPECTION, INSPECTOR GENERAL QUITS
As investigation into her conduct of the office of Health and Human Services Inspector G... Read more
Hospitals:
OUTLIER RULE COULD HELP HONEST HOSPITALS
Hospitals that have played by the rules when it comes to Medicare outlier payments could... Read more
OUTLIER RULE COULD HELP HONEST HOSPITALS
Hospitals that have played by the rules when it comes to Medicare outlier payments could... Read more
Long-Term Care:
LTCHs DUE FOR 2.2 PERCENT RAISE
Long-term care hospitals won’t have to deal with restrictions on the number of sat... Read more
LTCHs DUE FOR 2.2 PERCENT RAISE
Long-term care hospitals won’t have to deal with restrictions on the number of sat... Read more
Hospitals:
BAD DEBT COMPLIANCE -- WHAT TO WATCH FOR
The latest round of HHS Office of Inspector General inquiries into how well hospitals co... Read more
BAD DEBT COMPLIANCE -- WHAT TO WATCH FOR
The latest round of HHS Office of Inspector General inquiries into how well hospitals co... Read more
Kickbacks:
HOSPITAL GROUP CALLS FOR NEW SAFE HARBORS
Hospitals puzzled over what kinds of freebies they can provide their patients without ru... Read more
HOSPITAL GROUP CALLS FOR NEW SAFE HARBORS
Hospitals puzzled over what kinds of freebies they can provide their patients without ru... Read more
Medicaid:
OIG EYES BAY STATE SCHOOL SERVICES
Two school districts in Massachusetts could do more to ensure that their Medicaid claims... Read more
OIG EYES BAY STATE SCHOOL SERVICES
Two school districts in Massachusetts could do more to ensure that their Medicaid claims... Read more
Compliance:
OIG SPEAKS OUT TO WEST-COAST PROVIDERS
Looking for some first hand insight on what’s going on inside the HHS Office of In... Read more
OIG SPEAKS OUT TO WEST-COAST PROVIDERS
Looking for some first hand insight on what’s going on inside the HHS Office of In... Read more
Enforcement:
WAR ON TERROR MEETS WAR ON HEALTH CARE FRAUD
A Fayetteville, NY oncologist allegedly enmeshed in a plot to illegally send money to Ir... Read more
WAR ON TERROR MEETS WAR ON HEALTH CARE FRAUD
A Fayetteville, NY oncologist allegedly enmeshed in a plot to illegally send money to Ir... Read more
PROGRAM MEMO ROUNDUP
Physicians should expect an influx of patients seeking colorectal screenings in coming w... Read more
Physicians should expect an influx of patients seeking colorectal screenings in coming w... Read more
BILL WATCH
The following House bills were introduced: H.R. 960. A bill to amend part C of title X... Read more
The following House bills were introduced: H.R. 960. A bill to amend part C of title X... Read more
REGISTER WATCH
Besides changing the outlier payment rule (see Article, p. 4) and proposing a pay increa... Read more
Besides changing the outlier payment rule (see Article, p. 4) and proposing a pay increa... Read more
Reimbursement:
PHYSICIANS EKE OUT INCREASE IN FEE SCHEDULE FIX
The fruit of intensive lobbying by physician groups on Capitol Hill took formal shape Fe... Read more
PHYSICIANS EKE OUT INCREASE IN FEE SCHEDULE FIX
The fruit of intensive lobbying by physician groups on Capitol Hill took formal shape Fe... Read more
Medicare:
GOP PUSHING ON MEDICARE, BUT DIFFERENCES REMAIN
Hill Republicans see an opportunity to move quickly on Medicare prescription drugs and o... Read more
GOP PUSHING ON MEDICARE, BUT DIFFERENCES REMAIN
Hill Republicans see an opportunity to move quickly on Medicare prescription drugs and o... Read more
Hospitals:
HOSPITALS WEIGH IN ON STAFF PRIVILEGES AND KICKBACKS
At the behest of the American Medical Association, the HHS Office of Inspector General i... Read more
HOSPITALS WEIGH IN ON STAFF PRIVILEGES AND KICKBACKS
At the behest of the American Medical Association, the HHS Office of Inspector General i... Read more
SNFs:
FINE-TUNING THE ROLE OF NURSING HOME MEDICAL DIRECTORS
What’s the proper role of a nursing home medical director? According to the HHS Of... Read more
FINE-TUNING THE ROLE OF NURSING HOME MEDICAL DIRECTORS
What’s the proper role of a nursing home medical director? According to the HHS Of... Read more
Medicare:
FUTURE RETIREES MUST PINCH PENNIES TO PAY FOR MEDIGAP
With medical costs rising and employerprovided retiree coverage shrinking, allowing futu... Read more
FUTURE RETIREES MUST PINCH PENNIES TO PAY FOR MEDIGAP
With medical costs rising and employerprovided retiree coverage shrinking, allowing futu... Read more
Disease Management:
HEALTH PANEL SINGING NEW TUNE ON CARE MANAGEMENT
At hearings last year, House Ways and Means Health Subcommittee Chair Nancy Johnson (R-C... Read more
HEALTH PANEL SINGING NEW TUNE ON CARE MANAGEMENT
At hearings last year, House Ways and Means Health Subcommittee Chair Nancy Johnson (R-C... Read more
Home Health:
CMS ISSUES OASIS SURVEY MARCHING ORDERS
Starting in May, home health agencies won’t have to wonder if a friendly surveyor ... Read more
CMS ISSUES OASIS SURVEY MARCHING ORDERS
Starting in May, home health agencies won’t have to wonder if a friendly surveyor ... Read more
Pharmaceuticals:
MEDICAID Rx PURCHASING POOL GROWING
The first multistate Medicaid drug purchasing pool, announced Feb. 20 by Michigan and Ve... Read more
MEDICAID Rx PURCHASING POOL GROWING
The first multistate Medicaid drug purchasing pool, announced Feb. 20 by Michigan and Ve... Read more
Medicaid Perspectives:
ADMINISTRATION TOUTS UTAH MEDICAID MODEL
The White House hasn’t necessarily developed all the details of its plan, but its ... Read more
ADMINISTRATION TOUTS UTAH MEDICAID MODEL
The White House hasn’t necessarily developed all the details of its plan, but its ... Read more
REGISTER WATCH:
REGISTER WATCH:
Will disease management find a happy home in Medicare? Yet another demonstration project... Read more
REGISTER WATCH:
Will disease management find a happy home in Medicare? Yet another demonstration project... Read more
PROGRAM MEMO ROUNDUP
Hospitals who’ve encountered claims processing trouble spots under the outpatient ... Read more
Hospitals who’ve encountered claims processing trouble spots under the outpatient ... Read more
BILL WATCH
The following House bills were introduced: H.R. 863. A bill to amend title XVIII of th... Read more
The following House bills were introduced: H.R. 863. A bill to amend title XVIII of th... Read more
Medicare:
FY 2003 FUNDING FINAL AT LAST
Congress tweaked some administration recommendations in the fiscal year 2003 omnibus app... Read more
FY 2003 FUNDING FINAL AT LAST
Congress tweaked some administration recommendations in the fiscal year 2003 omnibus app... Read more
Hospitals:
SCHEDULE SLIPS FOR OUTLIER RULE
A new rule limiting outlier payments to hospitals will come out soon, but as a proposed ... Read more
SCHEDULE SLIPS FOR OUTLIER RULE
A new rule limiting outlier payments to hospitals will come out soon, but as a proposed ... Read more
Home Health:
HHS LAUNCHES HOME HEALTH QUALITY INITIATIVE
As promised, the Bush administration has taken its health care quality improvement effor... Read more
HHS LAUNCHES HOME HEALTH QUALITY INITIATIVE
As promised, the Bush administration has taken its health care quality improvement effor... Read more
Home Health:
HHAs WANT CMS TO KEEP HANDS OFF ALJs
The Centers for Medicare & Medicaid Services’ campaign to reform the appeals p... Read more
HHAs WANT CMS TO KEEP HANDS OFF ALJs
The Centers for Medicare & Medicaid Services’ campaign to reform the appeals p... Read more
Pharmaceuticals:
EMPIRE STATE JOINS AWP CRUSADE
New York Attorney General Eliot Spitzer joined a half dozen other states in suing drugma... Read more
EMPIRE STATE JOINS AWP CRUSADE
New York Attorney General Eliot Spitzer joined a half dozen other states in suing drugma... Read more
Antitrust:
DOJ, FTC REEXAMINE HEALTH CARE ANTITRUST
A series of government hearings starting this month could set the framework for how the ... Read more
DOJ, FTC REEXAMINE HEALTH CARE ANTITRUST
A series of government hearings starting this month could set the framework for how the ... Read more
ASCs:
MULTI-SPECIALTY PRACTICE FOUNDERS WITH ASC PROPOSAL
While recent advisory opinions suggest that there’s at least a little bit of wiggl... Read more
MULTI-SPECIALTY PRACTICE FOUNDERS WITH ASC PROPOSAL
While recent advisory opinions suggest that there’s at least a little bit of wiggl... Read more
Hospitals:
JOHNS HOPKINS CAPS OFF PATH PROBE
Johns Hopkins University emerged from a long-running physicians-at-teaching-hospitals au... Read more
JOHNS HOPKINS CAPS OFF PATH PROBE
Johns Hopkins University emerged from a long-running physicians-at-teaching-hospitals au... Read more
Medicare:
OIG CONTINUES TO FRET OVER MULTIPLE PROCEDURE CLAIMS
As part of an extensive series of reviews on how well Medicare contractors handle Medica... Read more
OIG CONTINUES TO FRET OVER MULTIPLE PROCEDURE CLAIMS
As part of an extensive series of reviews on how well Medicare contractors handle Medica... Read more
Credentialing:
SHRINK STINKS, PLAN THINKS, DEAL INKED
The misdeeds of a phony psychiatrist, the forthrightness of a health maintenance organiz... Read more
SHRINK STINKS, PLAN THINKS, DEAL INKED
The misdeeds of a phony psychiatrist, the forthrightness of a health maintenance organiz... Read more
Reimbursement:
GAO TARGETS NEW AWP PAYMENT HEMORRHAGE
As with most covered drugs and biologicals,Medicare pays way too much for blood clotting... Read more
GAO TARGETS NEW AWP PAYMENT HEMORRHAGE
As with most covered drugs and biologicals,Medicare pays way too much for blood clotting... Read more
Medicaid:
HHAs PREPARE TO DEFEND MEDICAID WAIVER PROGRAMS
For many disabled people depending on home care services through Medicaid, this could be... Read more
HHAs PREPARE TO DEFEND MEDICAID WAIVER PROGRAMS
For many disabled people depending on home care services through Medicaid, this could be... Read more
BILL WATCH
The following Senate bills were introduced: • S. 416. A bill to amend title XVIII... Read more
The following Senate bills were introduced: • S. 416. A bill to amend title XVIII... Read more
PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services Feb. 14 updated payment rules for certa... Read more
The Centers for Medicare & Medicaid Services Feb. 14 updated payment rules for certa... Read more
REGISTER WATCH
Responsibilities are shifting at the Centers for Medicare & Medicaid Services. A Feb... Read more
Responsibilities are shifting at the Centers for Medicare & Medicaid Services. A Feb... Read more
Reimbursement:
PHYSICIANS SCORE BIG IN OMNIBUS BILL
Physicians will get a 1.6-percent pay increase from Medicare, rather than a 4.4-percent ... Read more
PHYSICIANS SCORE BIG IN OMNIBUS BILL
Physicians will get a 1.6-percent pay increase from Medicare, rather than a 4.4-percent ... Read more
Home Health:
HOPE FOR 2003 RELIEF DIES WITH SENATE PROVISION
Despite the vocal support of many members of Congress, it appears there will be no reimb... Read more
HOPE FOR 2003 RELIEF DIES WITH SENATE PROVISION
Despite the vocal support of many members of Congress, it appears there will be no reimb... Read more
Physicians:
FEE SCHEDULE HEADACHES ABOUND
This summer, Medicare carriers will be doling out checks to physicians whose January and... Read more
FEE SCHEDULE HEADACHES ABOUND
This summer, Medicare carriers will be doling out checks to physicians whose January and... Read more
HIPAA:
CMS UNVEILS LONG-AWAITED HIPAA SECURITY RULE
After months of delays, the Centers for Medicare & Medicaid Services Feb. 13 finally... Read more
CMS UNVEILS LONG-AWAITED HIPAA SECURITY RULE
After months of delays, the Centers for Medicare & Medicaid Services Feb. 13 finally... Read more
False Claims Act:
CONTRACTORS DON'T HOLD THE BAG FOR PROVIDER FALSE CLAIMS
Whistleblowers can’t sic the False Claims Act on Medicare contractors simply for a... Read more
CONTRACTORS DON'T HOLD THE BAG FOR PROVIDER FALSE CLAIMS
Whistleblowers can’t sic the False Claims Act on Medicare contractors simply for a... Read more
Advisory Opinions:
CMS POLICY TRUMPS STRICT ANTI-KICKBACK ANALYSIS
A recent issuance from the HHS Office of Inspector General illustrates that the anti-kic... Read more
CMS POLICY TRUMPS STRICT ANTI-KICKBACK ANALYSIS
A recent issuance from the HHS Office of Inspector General illustrates that the anti-kic... Read more
Advisory Opinions:
OIG NIXES COPAY SUBSIDY
Drugmakers can’t use Medicare to subsidize patient assistance programs for financi... Read more
OIG NIXES COPAY SUBSIDY
Drugmakers can’t use Medicare to subsidize patient assistance programs for financi... Read more
Enforcement:
NORTHWESTERN CLOSES BOOK ON RESEARCH GRANT QUI TAM
An ex-employee of Northwestern University will collect more than $900,000 of a False Cla... Read more
NORTHWESTERN CLOSES BOOK ON RESEARCH GRANT QUI TAM
An ex-employee of Northwestern University will collect more than $900,000 of a False Cla... Read more
Medicaid:
IMD BILLING CAN STILL VEX STATES
Texas and California are the focus of the HHS Office of Inspector General’s latest... Read more
IMD BILLING CAN STILL VEX STATES
Texas and California are the focus of the HHS Office of Inspector General’s latest... Read more
Long-Term Care:
STAFFING, NOT POLICING, KEY ON ELDER ABUSE, SAYS AHCA
Legislation to decrease abuse of the elderly would be better if it focused on the need t... Read more
STAFFING, NOT POLICING, KEY ON ELDER ABUSE, SAYS AHCA
Legislation to decrease abuse of the elderly would be better if it focused on the need t... Read more
Reimbursement:
CMS EXPANDS BAD DEBT PAYMENT CUT
A 30-percent cut to bad debt reimbursement would apply to all eligible providers —... Read more
CMS EXPANDS BAD DEBT PAYMENT CUT
A 30-percent cut to bad debt reimbursement would apply to all eligible providers —... Read more
SCHIP:
SCHIP ENROLLMENT RISES
During fiscal year 2002, 5.3 million children were enrolled in the State Children’... Read more
SCHIP ENROLLMENT RISES
During fiscal year 2002, 5.3 million children were enrolled in the State Children’... Read more
BILL WATCH
The following Senate bills were introduced: S. 343. A bill to amend title XVIII of the... Read more
The following Senate bills were introduced: S. 343. A bill to amend title XVIII of the... Read more
REGISTER WATCH
Who’s having difficulty accessing physicians? CMS wants to know. The Centers for... Read more
Who’s having difficulty accessing physicians? CMS wants to know. The Centers for... Read more
PROGRAM MEMO ROUNDUP
The interest rate for Medicare overpayments has sunk to 10.75 percent, the lowest level ... Read more
The interest rate for Medicare overpayments has sunk to 10.75 percent, the lowest level ... Read more
Available Years:
2003