Medicare Compliance & Reimbursement
Feds May Look Into Podiatrists' Nail Debridement, Chiropractors' Services
Medicare could save $285 million per year if it cracked down on chiropractors billing for services that don't meet requirements, according to the HHS Office of Inspector General. In particular, the Centers for Medicare & Medicaid Services should keep chiropractors from billing for non-covered maintenance services, which accounted for $186 million in unallowed payments in 2001.
The OIG published its 2006 Red Book, a compilation of recommendations that could save Medicare and other programs money. Other recommendations included cracking down on podiatrists' inappropriate nail debridement services, encouraging the carriers to impose a "least costly alternative" policy on Lupron, and reviewing Part B therapy services.
DME Suppliers And Physicians Shouldn't Go Into Business Together, OIG Warns
A proposed deal in which a durable medical equipment supplier would provide DME to a physician could potentially violate the federal anti-kickback statute, the HHS Office of Inspector General said in Advisory Opinion 06-02.
The deal would have allowed the physician to become a DME supplier for non-Medicare patients, and the DME supplier would have rented space in the physician's office to supply DME directly to the physician's Medicare patients. The DME supplier would have paid rent, plus a percentage of revenues from DME sales and rentals. A trained professional would have been on-site to fit and supply the DME to the patients.
Both programs, taken together, pose a "significant risk of fraud and abuse," concluded the OIG.
Medicare Compliance & Reimbursement
- HEALTH PLANS:
Streamline Part D Turnaround Time To Head Off Potential Regulatory Changes
Most EHR systems fall to track revisions' sources, study shows.
Lagging Medicare Part D drug reimbursements [...] - PART D:
CMS Mulling Pharmacist Payment Adjustments To Shore Up Drug Benefit
Industry consolidation may narrow Medicare drug benefit to fewer plans next year.
News reports have highlighted [...] - P4P:
Home Care Not An Exception For P4P Shift
CMS plans to launch a P4P demo for the home care industry--soon.
Providers can't just ignore [...] - CONSULTATIONS:
OIG Initiates A New Crackdown On Consult Billing
Three out of four consults billed incorrectly, OIG says.
Consults look like a juicy target to [...] - COMPETITIVE BIDDING:
Bidding Rule Coming Out 'Very Soon,' CMS Promises
Bid items may vary for different bid areas.
Durable medical equipment suppliers soon will see the [...] - THERAPY:
HHAs Should Hold Off On Expedited Determination Notices For Part B Therapy
They can't reach for HHABNs either.
Home health providers can avoid unnecessary extra work if they [...] - NURSING HOMES:
RUG Software Could Be Costing LTC Facilities Thousands
Software snags may drag down nursing homes' per diems.
Without naming names, the Centers for Medicare [...] - BUDGET:
Senate, House Budget Committees Pass Budget Resolutions
Republican struggle could mean bad news for Medicare.
On March 16, the Senate passed the budget [...] - INDUSTRY NOTES:
Feds May Look Into Podiatrists' Nail Debridement, Chiropractors' Services
Plus: OIG offers opinion on physician's office housing a DME supplier.
Medicare could save $285 million [...]
