Home Health & Hospice Week
ZPICs Train Spotlight On Home Health, Hospice
It’s not just your imagination — you’ve gotten special attention from the ZPICs. One Zone Program Integrity Contractor "received almost $3 million for a completed project specifically examining potential fraud among home health providers," reveals the Government Accountability Office in a new report.
In 2012, ZPICs closed 557 investigations of home health and hospice providers, the GAO says in the report. While 380 of those originated from "other" sources, 298 came from MAC complaint units, the GAO says. Seventeen of the 557 cases were accepted by law enforcement.
Dollars: In 2012, ZPICs referred more than $88 million in claims for overpayment collection. But, only $13.3 million was actually recovered.
During that time period, ZPICs added 104 home health and hospice providers to prepay review and denied $7.3 million in claims. ZPIC-recommended auto-denials reached $8 million in the year, according to the report.
Other stats: In home health and hospice cases, ZPICs interviewed 1,455 beneficiaries, performed 126 onsite investigations, reviewed more than 8,300 claims in prepay review and more than 12,000 claims in postpay, and received nearly 350 requests for law enforcement cases, says the report at www.gao.gov/assets/660/658565.pdf.
Home Health & Hospice Week
- Prospective Payment System:
Billions In Rebasing Cuts Finalized In 2014 PPS Rule
Brace for wave of closures and sales. CMS has pared back the home health agen-cy [...] - Reimbursement:
LUPA, Supplies Payments Down From Proposed Rule
But LUPA rates still will double — or more. The tweaks CMS made to its [...] - Diagnosis Coding:
Bid Farewell To Extra Money For Certain GI Codes And More
Codes used in tens of thousands of episodes in 2012 get kicked off the case [...] - Industry Note:
Medicare Issues Refunds For Erroneous Prison Takebacks
Don’t expect reimbursement from appealed claims yet. CMS is finally correcting recoupments it made in [...] - Industry Note:
Use These Tips To Respond To ADRs Accurately And Save Your Reimbursement
New edits and probes continue to hit home health and hospice providers nationwide. For example, [...] - Industry Note:
Medicare HH Contractor Keeps The Heat On Hypertension Claims
Make sure your claims with hypertension codes can withstand medical review, or you’ll pay the [...] - Industry Note:
Give CMS Your 2 Cents On Newest Version Of Hospice Cost Report
You’ve got less than a month to give CMS a piece of your mind on [...] - Industry Note:
ZPICs Train Spotlight On Home Health, Hospice
It’s not just your imagination — you’ve gotten special attention from the ZPICs. One Zone [...] - Industry Note:
Tap This Education Tool For Memory Problems
Looking for a resource to share with your patients with memory problems and their families? [...] - Industry Note:
Animal Therapy Helpful For Dementia Patients, New Study Shows
A new study suggests your patients may benefit from interaction with animals. Therapy animals help [...]
