Home Health & Hospice Week
Data Mining-Triggered Edits On Deck
If your billing patterns make you stick out like a sore thumb, you may see pre-payment consequences sooner than you think. The Centers for Medicare & Medicaid Services is aiming to integrate its new data-driven Fraud Prevention System with its payment processing system by January, says the Government Ac-countability Office in a new report. "FPS analyzes Medicare claims data using models of fraudulent behavior, which results in automatic alerts on specific claims and providers, which are then prioritized for program integrity analysts to review and investigate as appropriate," GAO explains. However: CMS has "not yet developed reliable schedules for completing this activity," the GAO says of the FPS-payment system integration. The report is at www.gao.gov/products/GAO-13-104.
Home Health & Hospice Week
- Survey & Certification:
Surveys More Crucial Than Ever Under Alternative Sanctions
At least CMS won't publish your survey indiscretions in your local newspaper. Get ready to [...] - Compliance:
Get To Know These New Alternative Sanctions
Payment suspension sanction gets a little less punishing. Starting next summer, surveyors may start deploying [...] - Reimbursement:
CMPs May Crush HHAs
Daily fines add up quickly. Home care providers hungry for details of how surveyors, survey [...] - Regulations:
New Sanctions Put You At Surveyors' Mercy
Experts skeptical of checks and balances. What may bother home health agencies even more than [...] - Education:
Bone Up On PPS Final Rule
You can receive vital information on the 2013 prospective payment system final rule from the [...] - Industry Note:
Whistleblower Suit Leads To $1.3 Million Settlement
Hospice owner personally liable for $200K. More evidence that the feds are cracking down on [...] - Industry Note:
OIG Highlights Home Care Fraud
The HHS Office of Inspector General's latest semiannual report is playing the agency's greatest hits [...] - Industry Note:
Data Mining-Triggered Edits On Deck
If your billing patterns make you stick out like a sore thumb, you may see [...] - Industry Note:
New Year Brings Double Duty For Hospice Quality Data Reporting
January will be a busy month for hospices, quality reporting-wise. The hospice quality reporting program [...] - Industry Note:
Beware LUPA Glitch For High Therapy Episodes
If you want to receive the roughly $95 you're owed for a LUPA add-on amount [...] - Industry Note:
Benchmark Yourself Against MAC's LOS Data
Want to see where you stack up against your peers when it comes to non-cancer [...] - Industry Note:
Use Post-Discharge Study To Sway Hospitals
Looking for a way to convince hospitals that they should partner with you to reduce [...] - Industry Note:
Access Palliative Care Tool
If you're seeking educational materials to introduce the concept of palliative care to your patients, [...] - Industry Note:
Nurse Sentenced For Home Care Fraud In Detroit
A home care nurse defendant has drawn a two-and-a-half-year prison term in the $13.8 million [...]
