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Wachler & Associates Health Law Blog

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All Four RAC Regions Have Recently Added Additional Issues Approved for Review in RAC Audits

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);…

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EHR Incentive Payments Begin This Week

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%…

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Physicians Using EHRs Increased by 9%

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…

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Physician Convicted of Medicare Fraud for Violating the Anti-Kickback Statute

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…

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RAC Recovered $237.8 Million in Six-Month Period

Recovery Audit Contractors (RAC) recovered $237.8 million in the six-month period that ended in March. This amount is already three times more than the amount of money recovered in the previous year. According to recent estimates, CMS alleges that the total sum of Medicare improper payments exceeds $47 billion annually.…

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