Medicare Compliance & Reimbursement
CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS
Medicare contractors are boasting once again about the financial fallout from their medical review, fraud-fighting and other payment safeguard activities. Regional home health intermediary Palmetto GBA, for example, is touting the $872 million it withheld or recouped from providers in 2002 as costs savings to the government. Palmetto's benefit integrity unit helped "identify and pursue highly abusive and/or fraudulently billed services" to the tune of $98.8 million. Provider audits recovered $101.8 million and secondary payer efforts resulted in $400 million, the RHHI says. Meanwhile sister company Trailblazer Health Enterprises LLC boasts $832 million in payment safeguard savings in 2002, up from $792.1 million the previous year. Trailblazer is the fiscal intermediary for Texas, New Mexico and Colorado and the Part B carrier for Texas, Maryland, Delaware, Virginia and Washington, DC, among other Medicare claims processing duties. Lesson Learned: With Medicare contractors' powerful incentives to boast a tough track record on medical review and fraud fighting, compliance and solid documentation is as crucial as ever for health care providers' bottom lines.
Medicare Compliance & Reimbursement
- Budget:
HELP FOR STATES, RURAL AREAS IN SENATE BILL
The tax bill passed by the Senate May 15 includes $20 billion in fiscal relief [...] - Hospitals:
INPATIENT RULE LOWERS HIGH-TECH THRESHOLD
The Centers for Medicare and Medicaid Services says hospitals would get a 3.5-percent pay raise [...] - Medicare:
GAO: DEATH TO LOCAL COVERAGE PROCESS
The Centers for Medicare and Medicaid Services should strip Medicare contractors of their authority to [...] - Rehab:
75-PERCENT RULE ENFORCEMENT LOOMS FOR IRFs
Rehab hospitals are in line for a 3.3-percent increase in their Medicare payments - but [...] - Medicaid:
MEDICAID REVISIONS STILL UP IN AIR ON HILL, AMONG GOVERNORS
The National Governors Association task force on Medicaid is a long way from consensus on [...] - Pharmaceuticals:
PRIVATE LABELING LEADS TO CRIMINAL FINES
The feds mean business when it comes to drug pricing improprieties. Case in point: A [...] - Hospitals:
19 DRGs ON PER-DIEM CHOPPING BLOCK
Hospitals have long grumbled over the Centers for Medicare & Medicaid Services' post-acute transfer policy. [...] - Managed Care:
2004 M+C RATES LOW-BALL PLANS
Health plans aren't happy with the Centers for Medicare & Medicaid Services' 2004 Medicare+Choice payment [...] - Overpayments:
CONTRACTORS TOUT PAYMENT SAFEGUARD HAULS
Medicare contractors are boasting once again about the financial fallout from their medical review, fraud-fighting [...] - Kickbacks:
DEDUCTIBLE DEALS LEGAL BETWEEN HOSPITALS, MEDIGAP PLANS
Medigap insurers may be able to work deals with hospitals for cut rates on inpatient [...] - Help With HIPAA:
4 STEPS FOR HANDLING PRIVACY COMPLAINTS WITHOUT GETTING BURNED
Even if you have a top-notch privacy compliance program in place, you're bound to be [...] - HIPAA:
PART A PROVIDERS OPTIMISTIC ON HIPAA TRANSACTION STANDARDS
Medicare Part A providers are generally confident that they'll be ready for the Oct. 16 [...] - PROGRAM MEMO ROUNDUP
Skilled nursing facilities puzzled over Medicare policy for bill types 22x and 23x can take [...] - REGISTER WATCH
Skilled nursing facilities will see a 2.9 percent increase in their Medicare payments next year [...] - BILL WATCH
The following House bill was introduced: H.R. 2070. A bill to amend title XVIII of [...]
