Medicare Compliance & Reimbursement
WHY HOSPITAL-DOC ARRANGEMENTS CAN BE COMPLIANCE TIME-BOMBS
3 risk areas to watch for. Metropolitan Hospital in Grand Rapids, MI, along with a number of related organizations, agreed to shell out $6.25 million to settle allegations that they ran afoul of the Stark physician self-referral law. In particular, the Department of Justice alleged that Metropolitan:
The Stark law is designed to weed out fraud and abuse by preventing physicians from referring Medicare or Medicaid patients to health care organizations with which they have financial interests. The settlement also resolves DOJ contentions that Metropolitan billed for services that weren't adequately documented. "This settlement reflects the importance the [DOJ] places on compliance by all health care providers with the law, including those statutes governing financial relationships between hospitals and physicians," says Peter Keisler, assistant attorney general for DOJ's civil division. "We don't like it. We don't think it's fair," Metropolitan President and CEO Michael Fass told the Associated Press. "But for practical business reasons, we wanted to avoid a two-to-three-year legal battle at tremendous expense." The allegations arose from a whistleblower suit filed in 2002 by Mary Scott, former vice president of a Metropolitan affiliate. She'll collect $1.125 million as her bounty in the case. Lesson Learned: Financial arrangements between hospitals and physicians need careful review for potential Stark law problems.
If hospitals and physicians don't carefully pore over their financial arrangements for potential compliance problems, they could pay a steep price.
Medicare Compliance & Reimbursement
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Health plans are [...] - Home Care:
PRIVATE-PAY OASIS POLICIES MUST BE BASED ON THE WRITTEN WORD
CMS letter to surveyors fails to clear up confusion.
A new letter to state surveyors supposedly [...] - Home Care:
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But it doesn't apply to CMNs.
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5 TIPS FOR E-SIGNATURE SECURITY
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MENTAL HEALTH GROUPS, ER DOCS RAISE ALARM ON MEDICAID CUTS
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HOSPITALS CAN COLLECT MORE FOR QIO PHOTOCOPYING
After more than a decade, CMS ups hospitals' photocopying reimbursement.
Hospitals will be able to collect [...] - Hospitals:
WHY HOSPITAL-DOC ARRANGEMENTS CAN BE COMPLIANCE TIME-BOMBS
3 risk areas to watch for.
If hospitals and physicians don't carefully pore over their [...] - Exclusions:
TENET FORCED TO SELL REDDING MEDICAL CENTER
Hospital chain and OIG come to terms on potential Medicare ouster.
The HHS Office of Inspector [...] - Medicare+Choice:
A NEW WAY TO LURE BENEFICIARIES INTO MEDICARE+CHOICE
M+COs get another benefit option.
Health plans often have a hard time encouraging Medicare beneficiaries [...] - HIPAA:
TOP 9 HIPAA TRANSACTIONS RULE MISTAKES
Most Medicare claims aren't HIPAA compliant.
It's a good thing the Centers for Medicare & [...] - ANOTHER SHAKEUP AT HHS?
Thompson may step down next year.
If President Bush is re-elected next year, he'll have to [...]
