Medicare Compliance & Reimbursement
TX PROVIDERS MAY FACE IMD RECOUPMENTS
Ongoing OIG probe addresses Medicaid payments for IMD residents. The results: neither state has the controls in place to keep from billing the feds for care the states are supposed to foot the bill for themselves. The ongoing, nationwide 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 federal payments aren't available. In the latest reports, the OIG says Virginia owes the federal government more than $125,000 while Texas has to pony up nearly $1.3 million. Texas says it plans to recoup the money from providers - but the OIG points out that its review involved improper FFP claims from the state, not inappropriate payments to providers. The reports are titled "Review of Medical Claims Made to Medicaid for Beneficiaries Under the Age of 21 Who Reside in Institutions for Mental Diseases Within the State of Texas" (A-06-03-00009) and "Review Of Medicaid Claims Made For 21 To 64 Year Old Residents Of Private Institutions For Mental Diseases In The Commonwealth Of Virginia" (A-03-02-00206). To see the Texas report, go to http://oig.hhs.gov/oas/reports/region6/60300009.pdf. To see the Virginia report, go to http://oig.hhs.gov/oas/reports/region3/30200206.pdf. Lesson Learned: Health care providers in Texas may see Medicaid overpayment demands for claims connected with IMD residents.
In its latest attempt to assess whether states are blocking federal payments for most residents of institutions for mental diseases - as they're required to do under a longstanding, if oft-misunderstood, federal policy - the HHS Office of Inspector General casts its sights on the Virginia and Texas health departments.
Medicare Compliance & Reimbursement
- Rehab:
PROVIDERS GRAPPLING WITH INCOMING RULE
Rule could put some IRFs out of business. Now that the comment period has ended for [...] - Physicians:
CMS ANNOUNCES RATE CUT, BUT CONGRESS MAY REVERSE
Physicians are slated to receive a 4.5 percent cut in Medicare reimbursement under a final [...] - Home Health:
HHAs Preparing For M0175 Recoupments This Spring
Millions of dollars in takebacks based on patient hospital stays are on agencies' horizons. Despite [...] - Long-Term Care:
THREE-DAY HOSPITAL-STAY RULE STILL VEXES OIG
Nursing homes could face overpayment demands. Are skilled nursing facilities across the country inappropriately collecting [...] - Labs:
WHAT LAB SURVEYORS ARE LOOKING FOR
CLIA inspectors offer insider tips for a smoother survey. Laboratory inspectors around the nation are [...] - Pharmaceuticals:
CMS REVS UP STATES ON MEDICARE DRUG DISCOUNT CARDS
Program will go live next spring. Even though legislation establishing a Medicare-endorsed prescription drug program [...] - Home Health:
Bidding In, Copays Out In Latest Medicare Legislation
Home care provisions in flux.
Congressional leaders are stepping up the intensity of Medicare legislation negotiations, [...] - Pharmaceuticals:
ASSAULT CONTINUES ON DRUGMAKER RECORDKEEPING RULE
States call on CMS to withdraw controversial pharma reg. Drugmakers will have to go back to [...] - Rehab:
CAPS COULD SPAWN NEW ERA IN HOSPITAL-SNF RELATIONSHIPS
As long as the therapy caps are in place, many patients will be shuffled to [...] - Medicaid:
TX PROVIDERS MAY FACE IMD RECOUPMENTS
Ongoing OIG probe addresses Medicaid payments for IMD residents.
In its latest attempt to assess whether [...] - BILL WATCH
The following bill was introduced in the House: HR 3382. A bill to amend titles [...]
