Home Health & Hospice Week
INFUSION PROVIDERS HIT WITH FRAUD & ABUSE DEMO, TOO
The infusion requirements will look all too familiar to HHAs and suppliers: "The Centers for Medicare & Medicaid Services will now require infusion providers who operate in several South Florida counties to immediately resubmit applications to be a qualified Medicare infusion therapy provider," the Department of Health and Human Services says in an Aug. 20 release. "Those who fail to reapply within 30 days of receiving a notice to reapply from CMS will have their Medicare billing privileges revoked."
HHS is running the same requirements in an HHA demonstration in Los Angeles and Houston (see Eli's HCW, Vol. XVI, No. 26) and a DME demo in South Florida and Southern California (see Eli's HCW, Vol. XVI, No. 28).
And as with the HHA and DME projects, infusion providers "that fail to report a change in ownership; have owners, partners, directors or managing employees who have committed a felony; or, no longer meet each and every provider enrollment requirement will have their billing privileges revoked," HHS threatens.
Once providers leap the reenrollment hurdle, their trials aren't over. "Infusion providers that successfully complete the reapplication process may be subject to an enhanced review, including site visits," HHS warns.
Much of the fraudulent billing is related to HIV patients treated at infusion clinics, HHS says. One of the main defendants in an alleged fraudulent infusion billing scheme also owns multiple DME companies in addition to the infusion clinic, the release says.
Home Health & Hospice Week
- Prospective Payment System:
FINAL PPS RULE SLAMS AGENCIES ON MULTIPLE FRONTS
Case mix creep cut shoots up by one-third.
The feds have turned a deaf ear to [...] - OASIS:
MONITOR M0175--OR RISK LOSSES FOR A NEW REASON
There's more at stake for HHAs than just case mix scores.
The feds may be about [...] - Prospective Payment System:
DON'T LET M0110 BECOME YOUR NEW M0175
New 'early/later' question could pose major billing problems under revised PPS.
Home health agencies M0175 payment [...] - Billing:
TAKE THESE 5 STEPS TO GET M0110 RIGHT
Clinician-billing communication will be key to securing your rightful reimbursement.
You'll have a complicated new OASIS [...] - Competitive Bidding:
SPEAK OUT ABOUT BIDDING SNAFUS
Industry groups step in to help.
Don't go it alone if you're a home medical equipment [...] - Fraud & Abuse:
INFUSION PROVIDERS HIT WITH FRAUD & ABUSE DEMO, TOO
Home health agencies and home medical equipment suppliers aren't the only ones singled out for [...] - Reimbursement:
ANOTHER INTERMEDIARY SWITCHES TO HIGLAS ACCOUNTING SYSTEM
Expect RAP delays, mystery withholdings.
If you're experiencing a wave of billing and accounting confusion following [...] - Industry Notes:
POST-ACUTE PAYMENT REFORM DEMO MAY STILL AFFECT YOU
CMS to start knocking on doors to recruit.
A demonstration project that could result in more [...]
