Home Health & Hospice Week
Industry Note:
OIG Targets Inappropriate Managed Care Denials
Published on Fri Jun 22, 2018
In addition to looking at home health episodes that barely exceed the LUPA threshold, the HHS Office of Inspector General also plans to examine the issue of “Inappropriate Denial of Services and Payment in Medicare Advantage,” according to its latest Work Plan update. “A central concern about the capitated payment model used in Medicare Advantage is the incentive to inappropriately deny access to, or reimbursement for, health care services in an attempt to increase profits for managed care plans,” the OIG notes. The agency expects to release the resulting report in 2020.
Other Articles in this issue of
Home Health & Hospice Week
- Fraud & Abuse:
OIG Targets LUPA Gaming In Newest Work Plan Item
Feds will examine cases where one visit translates to additional thousands of dollars. Just where [...] - Compliance:
Take These 4 Steps To Head Off LUPA Troubles
Your PEPPER report could come in handy. With attention on low-visit episodes heating up, now’s [...] - Review Choice Demonstration:
Will Your State Be Next On Pre-Claim Review List?
Medicare to spend nearly $400 million on RCD project, it says. While recently released documents [...] - Medical Review:
Illinois HHAs Hope For Generous Exemptions To RCD
Even agencies that qualify for exemption will be subject to 5% ‘spot check.’ One of [...] - Enforcement:
OIG Racks Up Big Numbers In Latest Period
Nearly $1.5 billion in recoveries keeps the OIG on task. If you’re waiting for federal [...] - Hospice:
Hospice Fraud Settlement Leads To Execs' Salaries Splashed Across The Newspaper
Hospice nursing supervisor admits to hastening patients’ death with overmedication. Two hospice fraud and abuse [...] - Industry Note:
MAC Calls Off UPIC Scare
Stay alert to claims hitting S B6001, though. HHH Medicare Administrative Contractor Palmetto GBA is [...] - Industry Note:
OIG Targets Inappropriate Managed Care Denials
In addition to looking at home health episodes that barely exceed the LUPA threshold, the [...] - Industry Note:
Hospice Access A Problem For Kidney Dialysis Patients
Medicare patients on chronic kidney dialysis have “woefully poor access to hospice care,” says a [...] - Industry Note:
Senior Fraud Patrol Recovers Millions For Medicare
The Senior Medicare Patrol program continues to go strong, with the HHS Office of Inspector [...] - Industry Note:
Medicare To Ease Hospice Billing Next Month
Get ready for changes to your hospice billing July 2. Change #1: “A new hospice [...] - Reader Question:
VA Patient Successfully Sues For Home Care Continuation
The U.S. Department of Veterans Affairs has agreed to continue to provide home care for [...] - Industry Note:
Ohio Nonprofit Affiliate Group Grows
Ohio nonprofit Loving Care Hospice, based in London and Marysville, plans to join Ohio’s Hospice, [...]
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