Archive for June 2019
Inpatient Providers Settle Payment Dispute with CMS over Medicare Claims
The Centers for Medicare & Medicaid Services (CMS) has ended a two-year dispute settling appeals from inpatient rehabilitation facilities (IRF) over Medicare claims that were denied. The agency has agreed to pay 69 percent of the net payable amount for most claims that are pending appeal before the Medicare Administrative Contractor (MAC), the Qualified Independent…
Read MoreOCR Fact Sheet Clarifies BA Liability Under HIPAA
The U.S. Department of Health and Human Services Office for Civil Rights recently issued a new fact sheet on the Direct Liability of Business Associates under HIPAA. The release of the fact sheet immediately followed a settlement agreement with a business associate relating to a data breach that occurred in 2015 when hackers used a…
Read MoreOIG Alert: Beware of Genetic Testing Scam
The U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) recently sent out an alert about a fraud scheme involving genetic testing. The government watchdog agency said Medicare beneficiaries are being offered the chance to get tested for certain genetic conditions through the use of a simple cheek swab, but they…
Read MoreOIG Cracks Down on Home Health Questionable Billing Practices
A few years back, as part of its Work Plan, the U.S. Department of Health and Human Services Office of the Inspector General (OIG) announced it was seeking to identify home health agencies, supervising physicians, and geographic areas whose Medicare claims had characteristics similar to those observed by the agency in cases of home health…
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