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Florida ALFs latest target of Medicaid fraud investigators

Assisted Living Facilities (ALFs), and the patient placement agencies with which they work, have become the latest target of Florida’s Medicaid Fraud Control Unit (MFCU) investigators. Recently, these agencies have been conducting interviews with ALF owners, managers and marketing personnel at facilities where they suspect possible kickbacks in violations of the Florida Patient Brokering Statute […]

HME providers take hit following Univita collapse

Late last month, Univita Health Inc. filed for Chapter 7 bankruptcy. The move came shortly after the Miramar-based home health services provider shuttered its doors and terminated its Florida Medicaid contracts. Florida’s Agency for Health Care Administration (ACHA) has told providers they must continue to provide services to patients for services that were previously authorized […]

CMS: Medicare ACOs find success in savings, improved quality

The recent news that Medicare Accountable Care Organizations (ACOs) generated net savings of $411 million in 2014 and improved in most quality measures is being hailed as a success by the Centers for Medicare and Medicaid (CMS). These ACOs, which were established under the Affordable Care Act, are the center of the nation’s healthcare reform […]

Bundled payments: What impact will they have on your practice?

In an effort to shift payment models away from fee-for-service, more healthcare providers are being paid based on their ability to provide high-quality care in a more coordinated fashion through bundled payment arrangements. To that end, The Centers for Medicare & Medicaid Services (CMS) recently announced that more than 2,100 acute care hospitals, skilled nursing […]

Physicians: Abandoning medical records can get you in trouble

The Florida Board of Medicine recently announced that there has been an increase in the number of reports concerning abandoned medical records. Physicians are either closing or relocating their practices and no longer caring for a certain population of patients. Although there are rules and statutes in place that govern the amount of time physicians […]

New legislation regulates Florida addiction recovery residences

During the last Florida legislative session, a bill designed to clamp down on addiction recovery residences was passed with little fanfare. In June, Gov. Rick Scott signed HB 21 into law. The legislation, which took effect July 1, creates ss. 397.487 and 397.4871, F.S., which require the Florida Department of Children and Families to create […]

Compounding pharmacies in the eye of investigative storm

In the last year or so there have been a number of stories in the media about investigations into wrongdoing by compounding pharmacies, marketing companies and physicians. At last count there were nearly 100 federal investigations underway for what the feds believe are questionable financial relationships involving these three entities. In some instances, physicians are […]

Ready or not here ICD-10 comes

With less than three months until the implementation of the long-awaited ICD-10, it appears many providers are still unprepared – particularly in the areas of testing and assessing the impact it will have on revenue. A new report published by AHIMA and the eHealth Initiative finds that while half of the respondents had completed test […]

CMS’ fraud crackdown relies on high-tech analytics

The government’s crackdown on Medicare fraud is paying off and healthcare providers that bill the government program would be well advised to know that the Centers for Medicare & Medicaid Services is using a high-tech analytics system to identify inappropriate payments. Aptly named the “Fraud Prevention System,” the program has identified or prevented $820 million […]

CMS to cut providers a break when it comes to ICD-10 deadline

With the implementation of ICD-10 just around the corner (Oct. 1) comes word from the Centers for Medicare & Medicaid Services that it will not deny claims made under the Part B physician fee schedule if there are coding errors. The guidance notice, which was issued with the blessing of the American Medical Association, is […]

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It is not intended as professional advice and should not be construed as such.