Medicare Compliance & Reimbursement
Nevada Radiology Group Gets $2 Million Fine
Plus: One RAC reveals information about how it will evaluate claims during its review process. The physician-owned practice will pay $2 million to resolve allegations that it submitted false claims to Medicare, the OIG announced in a March 25 press release. The settlement -- one of the largest ever negotiated under the OIG's Civil Monetary Penalties authority -- will resolve the following allegations against the practice: • Improperly providing diagnostic tests to Medicare beneficiaries without the required treating physicians' orders • Billing for certain tests under CPT codes not supported by the medical records • Failing to satisfy "certain other Medicare billing and coverage requirements," the OIG noted in its press release. "OIG will investigate and pursue enforcement actions against health practitioners who engage in a pattern of billing Medicare for services that were not ordered by the patients' treating physicians," said Inspector General Daniel Levinson in a statement.
Medicare Compliance & Reimbursement
- RED FLAGS RULE:
No Red Flags Program? You Could Be Losing Thousands
Tip: Institute your Red Flags program ASAP. You may think the government is implementing the [...] - MEDICARE ADVANTAGE :
CMS Overhauls Medicare Advantage Program
Oversight of MA could tighten significantly. CMS is buckling down on the Medicare Advantage (MA) [...] - RED FLAGS RULE :
Act Quickly If Your Practice Identifies a Red Flag
Identity theft is nearly a $50 billion industry. You've implemented a Red Flags program at [...] - BILLING :
Make Sure You Charge For All Your Services
Measure charges and take action, experts say. So you've got a handle on your accounts [...] - DIAGNOSIS CODING :
CMS Dismisses Attachment D Concerns
Sequencing, risk adjustment not harmed by new guidance on secondary diagnosis coding, CMS official maintains. [...] - PART B REVENUE BOOST :
Brush Up on Your ICD-9 Know-How With These 3 Tips
Confused about fifth digits or V codes? Look no further. Insurers base your reimbursement on [...] - CODING COACH :
Keep Chronic Pain Denials at Bay With Surefire Diagnosis Tips
Be careful not to put words in your physician's mouth, or risk audit woes. Imagine [...] - INDUSTRY NOTES :
Nevada Radiology Group Gets $2 Million Fine
Plus: One RAC reveals information about how it will evaluate claims during its review process. [...] - IN OTHER NEWS ...• If your head is spinning with all of the changes between PQRI and e-prescribing, CMS has just the tool for you.
New MLN Matters article MM6394, dated March 20, offers a full breakdown of who is [...]
