Medicare Compliance & Reimbursement
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils that lurk within the regulatory tangle snare unexpected victims. Case in point: School districts can bill Medicaid for some school-based health services, but the HHS Office of Inspector General has long worried that many districts just aren't getting the rules. But OIG anxiety isn't the end of the story - if blunders conceivably rise to the level of fraud, the stakes can be huge. Case in point: Oregon Attorney General Hardy Myers and U.S. Attorney Michael Mosman March 14 announced that the Beaver State's Gaston School District has agreed to pay more than $230,000 to resolve charges that it defrauded Medicaid. The alleged misconduct included failing to properly document claims, billing for non-reimbursable services and submitting claims for services students didn't actually receive. Gaston denies the charges. The case marks the second of its kind in Oregon. Previously, Eagle Point School District paid $1.2 million to resolve similar claims. Lesson Learned: Compliance experts should be aware that the nation's school districts are badly in need of Medicaid billing expertise.
Medicare Compliance & Reimbursement
- Legislation:
MEDICAID CUTS HANG IN THE BALANCE
The House and Senate are duking it out over $93 billion in Medicaid cuts, and [...] - Quality Improvement:
NEWSPAPER ADS COMPARING HHA OUTCOMES WEEKS AWAY
The Centers for Medicare & Medicaid Services will trumpet home health agency patient outcomes in [...] - Pharmaceuticals:
COURT OKS MICHIGAN MEDICAID RX PROGRAM
Michigan may go forward with its effort to obtain deep discounts from prescription-drug manufacturers for [...] - Medicare+Choice:
MOST POPULAR M+C PLANS TO GET TWO PERCENT RAISE
In 2004, managed care plans serving the majority of Medicare+Choice beneficiaries will again see only [...] - Compliance:
HEALTH CARE DIRECTORS MUST SPEAK UP ON COMPLIANCE
As the Enron fiasco continues to play out and the HealthSouth debacle puts the corporate [...] - Medicare:
MEDICARE REGULATORY REFORM MOVES FORWARD, BUT HALTINGLY
It's nice to know that even in the House Ways and Means Committee, occasionally a [...] - Self-Referral:
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with [...] - Quality of Care:
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very [...] - Physicians:
STAFFING COMPANIES IN LINE FOR STEPPED UP SCRUTINY
Staffing companies that contract with physicians to staff emergency rooms and other hospital departments could [...] - HIPAA:
PROVIDERS ADOPT 'JUST-IN-TIME' APPROACH TO HIPAA COMPLIANCE
Have you deferred a good chunk of your Health Insurance Portability and Accountability Act compliance [...] - Medicaid:
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils [...] - Reimbursement:
NEW APPROACHES TO NEW TECH PAYMENTS
Health care providers that deal extensively with new and emerging technologies may soon see some [...] - Medicaid:
AUDIOLOGISTS FACE NEW RULES FOR MEDICAID
Audiologists would have to meet a new set of requirements to provide services - including [...] - Medicare+Choice:
FINAL M+C APPEAL RULE EASES ADVANCE NOTICE REQUIREMENT
Medicare+Choice organizations will have to notify enrollees two days prior to terminating services under a [...] - PROGRAM MEMO ROUNDUP
Health care providers that bill Medicare for Part B mental health services should take special [...] - BILL WATCH
The following House bills were introduced:
H.R. 1539. A bill to amend title XVIII of [...]
