Archive for February 2016
CMS issues new condition code for home health claims
The Centers for Medicare and Medicaid Services (CMS) has added a new condition code that will allow home health claims for subsequent episodes to process, even if skilled nursing services are not required. The change takes effect July. 1 Currently, any home health claim that is submitted without skilled nursing visits are automatically returned to…
Read MoreCMS clarifies 60-day overpayment rule
The Centers for Medicare & Medicaid Services (CMS) has published its long-awaited final rule that details the reporting and returning of Medicare Part A and B overpayments. The proposed rule left providers asking many questions. The final rule provides needed clarity and consistency in the reporting and returning of self-identified overpayments. It is designed to…
Read MoreTRICARE Billing Scandal Intensifies as Feds Target More Compounding Pharmacies
Allegations of fraudulent billing practices involving compounding pharmacies and specialty creams is rearing its ugly head again. Now, the U.S. Department of Justice is investigating what is suspected to be half a billion dollars in healthcare fraud linked to these creams used to treat pain. TRICARE, the health insurance program for members of the U.S.…
Read MoreSocial media posts can be used to detect healthcare fraud
In George Orwell’s novel Nineteen Eighty-Four, citizens of Oceania, a totalitarian state, are under surveillance at all times and constantly reminded that Big Brother is watching them. Today, with the advancement of digital technologies – from cameras on the street and in stores, to cookies gathered from the Internet – most of us are being watched…
Read MoreFirm partners with LicenseLogix to assist clients with business licensing needs
As many business owners know, or often find out as they are launching their business, there are many rules and regulations that must be followed. Just about every business – particularly those in the healthcare field – needs some kind of license or permit to operate legally. In fact, there are more than 150,000 filing…
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