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);…
The Centers for Medicare and Medicaid issued a new rule that will make it easier for hospitals to use telemedicine when treating patients. The final rule, which takes effect sixty days following its publication, removes unnecessary burdens for hospitals and critical access hospitals (CAHs) to use telemedicine to serve patients…
Over $30 billion has been set aside by the government to use for incentive payments in an effort to get health care professionals to switch to electronic records. One reason for the push towards electronic records is the ability exchange patient information between systems. As a way to efficiently capture…
The ONC announced last Wednesday that the Medicare electronic health record (EHR) incentive payments will begin disbursement this week. The payments will be made to providers who have met all of the program conditions, including the meaningful use requirements. Eligible participants can expect to receive a payment based on 75%…
The Office of the Inspector General (OIG) issued an unfavorable advisory opinion with respect to a joint venture between a pharmacy and long term care facilities. The proposed arrangement would include a long term care pharmacy incorporated in the requestor’s market area. The owners of the long term care pharmacy…
The percentage of physicians in the United States using electronic health records (EHR) has increased by nine percent (20% to 29%) over the past twelve months. The push towards electronic records has been firmly supported by the current and previous presidential administrations. The Obama Administration aims to have at least…
On May 4, 2011, the Seventh Circuit Court was faced with the issue of whether a doctor’s actions violated the anti-kickback statute (United States of America v. Borrasi). Dr. Roland Borrasi was convicted of Medicare fraud after he accepted payments in the form of a salary from a psychiatric hospital…