Medicare Compliance & Reimbursement
MANUAL UPDATE ROUNDUP
A common working file edit flagging too many immunosuppressive drug claims should soon get fixed by the durable medical equipment regional carriers. In an Oct. 17 one-time notification, the Centers for Medicare & Medicaid Services points out that an edit designed to weed out duplicate immunosuppressive drug claims isn't working properly. The problem: The edit sends out an alert whenever immunosuppressive drug claims are submitted along with other, non-immunosuppressive drug DME items on the same date of service by the same supplier (Change Request 2910; http://oig.hhs.gov/fraud/advisoryopinions/aofaq.html). The agency mandates that the edit be fixed by April 1, 2004. In other recent manual updates, CMS:
Medicare Compliance & Reimbursement
- Medicare Reform:
LEGISLATORS STILL DISAGREE ON ROLE OF PRIVATE PLANS
Past the initial deadline for a final bill, experts say process could go until December. As [...] - Hospitals:
TURF BATTLE OVER SPECIALTY HOSPITALS CONTINUES
GAO weighs in on the debate. The growing popularity of specialty hospitals has general hospitals [...] - Home Health:
COPAY THREAT PERSISTS AS HOME CARE INDUSTRY STRIKES BACK
Medicare home care funding is more vulnerable to cuts than ever as negotiations continue over [...] - Labs:
CLIA SURVEYORS AWAIT GREEN LIGHT FROM FEDS
Find out how surveyors intend to handle deficiencies in the meantime. CLIA inspectors may be [...] - Long-Term Care:
SENIORS' HOME EQUITY EYED AS KEY TO PAYING LTC BILLS
Well-off seniors benefitting from Medicaid while state budgets languish, Scully says. Seniors have $1.5 trillion [...] - Rehab:
REHAB PROVIDERS LAUNCH NEW SALVO AGAINST 75-PERCENT RULE
IRFs will shut down unless CMS acts, rehab hospitals argue. Inpatient rehabilitation facilities are in [...] - Business Arrangements:
OIG SHINES LIGHT ON ADVISORY OPINIONS
What to expect if you want an OIG stamp of approval on your business needs. The anti-kickback [...] - Pharmaceuticals:
DRUGMAKER RECORDKEEPING RULE SPARKS GRASSLEY'S IRE
False Claims Act architect says Medicaid rebate rule will foil whistleblowers. Drugmakers who thought the [...] - Medicaid:
CMS TO HIRE 100 MEDICAID-MAXIMIZATION COPS
The White House Office of Management and Budget has approved hiring 100 new federal employees [...] - Hospitals:
IS MANDATORY QUALITY REPORTING ON THE HORIZON FOR HOSPITALS?
CMS chief Tom Scully isn't happy about early results on voluntary reporting. Last December's agreement [...] - EMTALA:
IMPROPER PSYCH TRANSFERS PROMPT INVESTIGATION
ED docs fired as health department probes EMTALA problems. The Emergency Medical Treatment and Active [...] - BILL WATCH
Bills introduced in the House: HR 3299. A bill to provide for prescription drugs at [...] - MANUAL UPDATE ROUNDUP
A common working file edit flagging too many immunosuppressive drug claims should soon get fixed [...]
