The Centers for Medicare and Medicaid Services announced last week that in the past year healthcare providers have received $158.3 million in EHR incentives. The incentives have been advocated by the Obama administration to encourage doctors and hospitals to use digital health records that meet federal standards. This encouragement coincides…
Healthcare providers that wish to participate in CMS’ Pioneer ACO Model program must submit a letter of intent to CMS by June 10, 2011. This program is the latest initiative in the development of ACOs. The Pioneer ACO program is an opportunity for groups of providers that are already accustomed…
The Office of the Inspector General issued a favorable opinion regarding an affiliation between an Air Force medical group and a community hospital. The arrangement involves an Air Force medical group (medical group) located on a military base and a community hospital located near the base. As a result of…
The Department of Health and Human Services (HHS) has issued a notice of proposed rulemaking to modify the HIPAA Privacy Rule in accordance with the Health Information Technology for Economic and Clinical Health Act (HITECH) requirement that users of electronic health records (EHRs) provide a more extensive accounting of disclosures…
A sleep medicine and durable medical equipment company, Areté Sleep LLC, Areté Sleep Therapy LLC, and Areté Holdings LLC will pay a $650,000 settlement pursuant to federal authorities discovering the company to have submitted false claims to Medicare over a seven year span. According to federal prosecutors, the false claims were…
ACO Start-Up Costs According to a study conducted by the American Hospital Association, the costs associated with starting an accountable care organization (ACO) range from $5.3 million to $12 million. The study was based on a review of the start up costs of four ACOs currently in existence. Additionally, it…
Over $365 Million in Improper Payments Identified By RACs Since October 2009 CMS recently reported that RACs have identified $312.2 million in overpayments from October 2009 through March 2011. During the same period, $52.6 million in underpayments were identified. While these figures are well below the over $1 billion in…
On May 16, the Office of the Inspector General for the Department of Health and Human Services released the report from its audit of physician therapy services provided during home health episodes. The report outlines the OIG’s findings that the Centers for Medicare and Medicaid Services (CMS) made duplicate payments…
As of April 20, 2011, a statement, writing, or action by a health care professional to an individual, or an individual’s family, that expresses sympathetic feelings towards that individual’s pain or death cannot be used against the professional in an action for medical malpractice. However, this bill does not apply…
DCS Healthcare: The Region A RAC added three new medical necessity claims to its approved issues list. These claims are: Peripheral/cranial nerve and other nervous system procedures with MCC (MS-DRG 040); ECMO or tracheostomy with MV 96+ hrs or PDX except face, mouth and neck with major O.R. (MS-DRG 003);…