Archive for November 2016
CMS: Ignorance not an excuse when it comes to liability
The Centers for Medicare & Medicaid Services (CMS) recently released a policy change that provides additional conditions for determining when a contractor must assume a physician, provider, or supplier should have known about a policy or rule. Currently, CMS requires its contractors to consider at least one of three conditions when assuming that a provider,…
Read MoreOIG’s Far-reaching 2017 Work Plan Designed to Root Out Fraud and Abuse
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently released its work plan for 2017 and its target list is ambitious. Each year, the agency releases a plan that summarizes new and existing reviews and areas where it will focus its attention for the coming year. It also shows…
Read MoreCMS offers plan (again) in hopes of clearing Medicare appeals backlog
Hospital executives who are tired of waiting for their Medicare appeals cases to be settled are being presented with an option. The Centers for Medicare and Medicaid is offering to pay hospitals 66 percent of the net allowable for short-term inpatient stays in exchange for dropping their pending appeals of denied claims. CMS recently announced…
Read MoreHome Healthcare Agencies to Realize $130M in Medicare Reimbursement Cuts in 2017
Home healthcare agencies can expect to see a 0.7 percent drop in Medicare reimbursements next year, according to the Centers for Medicare & Medicaid Services. CMS announced the final changes to the Medicare home health prospective payment system (HH PPS) on Oct. 31. The new rule, which takes effect on Jan. 1, 2017, means Medicare…
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