Medicare Compliance & Reimbursement
IMD BILLING CAN STILL VEX STATES
Texas and California are the focus of the HHS Office of Inspector General’s latest reckonings of whether or not state Medicaid agencies properly block federal payments for most residents of institutions for mental diseases.
The ongoing series of reviews is designed to ensure that states aren’t claiming federal financial participation under the Medicaid program for IMD residents between the ages of 21 and 64 — a class of patients for which, under longstanding Medicaid policy, federal payments aren’t available.
The results: Texas claimed just over $500,000 in improper FFP for IMD residents between 1997 and 2000, according to “Review of Medicaid Claims for 21 to 64 Year Old Residents of Private Psychiatric Hospitals in Texas That Are Institutions for Mental Diseases” (A-06-02-00026). California fared very well with medical and ancillary claims, but struggled a bit with inpatient psychiatric claims at private facilities, the OIG says in a trio of reports — “Review of Medicaid Inpatient Psychiatric Claims for 21 To 64 Year Old Residents of Private Psychiatric Hospitals That Are Institutions for Mental Diseases in California During The Period July 1, 1997 Through January 31, 2001” (A-09-02-00061), “Review of Medical and Ancillary Medicaid Claims for 21 To 64 Year Old Residents of Private Psychiatric Hospitals That Are Institutions for Mental Diseases in California During The Period July 1, 1997 Through January 31, 2001” (A-09-02-00079) and “Review of Medical and Ancillary Medicaid Claims for 21 to 62 Year Old Residents of State-Operated Psychiatric Hospitals That Are Institutions for Mental Diseases in California During the Period July 1, 1997 Through February 28. 2001” (A-09-01-00107).
To see the reports, go to http://oig.hhs.gov/w-new.html.
Medicare Compliance & Reimbursement
- Reimbursement:
PHYSICIANS SCORE BIG IN OMNIBUS BILL
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FEE SCHEDULE HEADACHES ABOUND
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CMS UNVEILS LONG-AWAITED HIPAA SECURITY RULE
After months of delays, the Centers for Medicare & Medicaid Services Feb. 13 finally unveiled [...] - False Claims Act:
CONTRACTORS DON'T HOLD THE BAG FOR PROVIDER FALSE CLAIMS
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CMS POLICY TRUMPS STRICT ANTI-KICKBACK ANALYSIS
A recent issuance from the HHS Office of Inspector General illustrates that the anti-kickback statute [...] - Advisory Opinions:
OIG NIXES COPAY SUBSIDY
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NORTHWESTERN CLOSES BOOK ON RESEARCH GRANT QUI TAM
An ex-employee of Northwestern University will collect more than $900,000 of a False Claims Act [...] - Medicaid:
IMD BILLING CAN STILL VEX STATES
Texas and California are the focus of the HHS Office of Inspector General’s latest reckonings [...] - Long-Term Care:
STAFFING, NOT POLICING, KEY ON ELDER ABUSE, SAYS AHCA
Legislation to decrease abuse of the elderly would be better if it focused on the [...] - Reimbursement:
CMS EXPANDS BAD DEBT PAYMENT CUT
A 30-percent cut to bad debt reimbursement would apply to all eligible providers — not [...] - SCHIP:
SCHIP ENROLLMENT RISES
During fiscal year 2002, 5.3 million children were enrolled in the State Children’s Health Insurance [...] - Enforcement:
MSP BLUES
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The interest rate for Medicare overpayments has sunk to 10.75 percent, the lowest level in [...]
