EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC DRG Code 147

As with any type of medical review, the physician face-to-face encounter needs to be a major focus. Just when you thought your workload couldn’t get any heavier, along comes eleventh-hour news of the Review Choice Demonstration’s five-year extension — and [...]

‘Terminal illness not supported’ shot down over half of claims in latest MAC TEP round. With hospice claims getting more scrutiny than ever, you’ll want to make sure you are protected against one of the biggest claim-killers — failure to [...]

Medicare Advantage plans may be finally catching on to the fact that covering non-medical home care services is a good idea for their members. So suggests a new report from The Long-Term Quality Alliance and research firm ATI Advisory. The [...]

The government is ramping up HIPAA violations, not slowing them down. When the ED gets busy, adherence to the privacy rules can sometimes go out the window — but it shouldn’t. The Office of Civil Rights (OCR), which oversees the [...]

Louisiana racks up highest HH utilization rate, according to new report. Although it seems like nothing can stop the rise of Medicare Advantage plans, a watchdog agency recommen­dation might have some effect. In its annual June report to Congress, the [...]

Compliance for claiming contractor status is a ‘moving target,’ attorney warns. If you think avoiding burdensome overtime requirements by classifying workers as independent contractors is a good idea, you may need to think again. Earlier this month, the Department of [...]

Plus: Hospitals are skirting proration for HH discharges, OIG accuses. If you think including discharges to hospice in Medicare’s proration policy for hospital discharges is adversely affecting hospice referrals, an influential advisory body to Congress does not agree. Reminder: The [...]

Watchdog agency pushes for HHA surety bonds — again. Home health agencies just can’t seem to get a break from the HHS Office of Inspector General lately. In the past week, the OIG has issued three reports highlighting problems with [...]

Shifting hospital discharges from facilities to home care helped shave $17 million off Medicare spending. A new analysis of Medicare’s Compre­hensive Care for Joint Replacement (CJR) model shows that home care can produce savings for the benefit program. Reminder: Under [...]

Take these 4 steps to protect your agency. The Patient-Driven Groupings Model contains sweeping changes. Don’t let one of the most important reimbursement revisions — to Low Utilization Payment Adjustments — get lost in the shuffle. A crucial concept home [...]