Medicare Compliance & Reimbursement
EPOGEN, Rx CHARGES STAND OUT IN OUTPATIENT PAYMENT REVIEW
Providers of outpatient services should take note that their claims are under scrutiny by the HHS Office of Inspector General. In a recent audit report - part of a nationwide series of reviews - the OIG takes the measure of potentially excessive Medicare payments fiscal intermediary United Government Services made to institutional providers of outpatient services. What stood out in the review were claims for the drug Epogen - one dialysis facility incorrectly billed for 9.9 million units of the drug and was paid more than $80,000. Outpatient pharmacy charges also seemed excessive in some cases, the OIG says, with $1.3 million billed by one provider on only seven claims. In the past, such errors have been found out to be the result of clerical blunders, the watchdog agency notes in "Review of Potentially Excessive Medicare Payments United Government Services" (A-01-02-00516). The OIG adds that the apparent overpayments were isolated instances and didn't reflect widespread problems. Nevertheless, UGS is taking steps to address the issue. To see the report, go to http://oig.hhs.gov/oas/reports/region1/10200516.pdf.
Medicare Compliance & Reimbursement
- Medicare Drug Benefit:
CONGRESS DESPERATELY SEEKING WAYS TO RETOOL DRUG BILLS
With the White House's 2003 Medicare prescription-drug proposal now in the mix, members of Congress [...] - Medicaid:
NGA MEDICAID PANEL MULLING MORE THAN WHITE HOUSE PLAN
The ten-member governors' task force convened by the National Governors Association hopes to come up [...] - Medicare Reform:
HEALTH PLANS FIGHTING NEGATIVE PERCEPTIONS IN REFORM BATTLE
Health plans hoping to see a larger population of Medicare beneficiaries move into private plans [...] - Dual Eligibles:
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High on states' wish list for Congress is legislation to shift Medicaid costs for beneficiaries [...] - Litigation:
GALLUP SUES SCULLY OVER ALLEGED BULLYING
The Gallup Organization polling firm has filed suit against Centers for Medicare & Medicaid Services [...] - Hospitals:
HOSPITAL-PHYSICIAN BUSINESS DEALS UNDER SCRUTINY
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HOSPITALS BEMOAN OUTLIER CHANGES
Hospitals should brace themselves for potential reimbursement shortfalls under the Centers for Medicare & Medicaid [...] - Physicians:
PHYSICIANS CAN EARN CMEs THROUGH QIOs
Physicians have one more incentive to get involved with the Centers for Medicare & Medicaid [...] - Medicare:
OIG SLAMS CODING SEMINAR COMPANY
Have you been duped by coding and billing education companies that tout non-existent formal affiliations [...] - Fraud & Abuse:
YOUR PATIENTS ARE WATCHING YOU
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PER-PATIENT FEE STRUCTURES RAISE COMPLIANCE RED FLAGS
If you're about to ink a business deal with another health care provider that involves [...] - Hospitals:
OUTLIER BLUNDERS GO BOTH WAYS
Hospitals face ever-mounting attention on Medicare outlier payments - and are bracing for a new [...] - Overpayments:
EPOGEN, Rx CHARGES STAND OUT IN OUTPATIENT PAYMENT REVIEW
Providers of outpatient services should take note that their claims are under scrutiny by the [...] - Long-Term Care:
SNFs FACE ELIGIBILITY SCRUTINY
Skilled nursing facilities across the country could soon be asked to hand back Medicare dollars [...] - Coverage:
MRA COVERAGE EXPANDS
Health care providers will soon have more opportunities to collect Medicare reimbursement for magnetic resonance [...] - HIPAA:
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NEW RULES HIT HOME FOR HOSPITAL SURVEYS
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Durable medical equipment suppliers have a host of new "K" codes to get familiar with, [...] - REGISTER WATCH
The Centers for Medicare & Medicaid Services' tardiness in implementing a national fee schedule for [...] - BILL WATCH
The following House bills were introduced:
H.R. 1784. A bill to amend title XVIII of [...] - WHO'S WHO IN MEDICARE
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