Plus: Neuro diagnosis codes are most common, data shows. As hospice continues its explosive growth trajectory, policy- and lawmakers are looking at how to get a handle on the benefit and ensure its program integrity. To that end, the 2024 [...]
For hospice, terminal prognosis continues to be providers’ Achilles heel. Targeted Probe and Educate medical review is back, and it’s soaking up agencies’ precious time and resources. But before TPE, post-payment medical review from the HHH Medicare Administrative Contractors resumed [...]
Number of users, spending also are down, latest data shows. Law- and policymakers will base any legislative and policy decisions on facts and figures the Medicare Payment Advisory Commission provides in its annual report to Congress. MedPAC’s report issued March [...]
Highest-ranking states may surprise you. Medicare’s payment error rate for hospices and home health agencies together varies widely from state to state, shows the latest Medicare payment error report. Among the many figures included in the report is a state-by-state [...]
High claims volume doesn’t necessarily translate to high error rates. Wondering where the feds might choose to crack down next with stepped up claims review or more intense fraud and abuse-fighting activity? Stats included in the latest Medicare payment error [...]
Hint: Suggested E/M documentation changes could balance shortcomings. If a hefty portion of your Part B take-home pay is tied to E/M office visits, you may want to review recent Medicare proposals. However, depending on your specialty and the number [...]
The moratoria on new home health agencies continues in all counties in Florida, Illinois, Michigan, and Texas, according to a notice in the Aug. 2 Federal Register. “A significant potential for fraud, waste, and abuse continues to exist regarding those [...]
Hint: Suggested E/M documentation changes could balance shortcomings. If a big part of your Medicare pay is tied to evaluation and management (E/M) office visits, you may be concerned about recent proposals from CMS. But depending on your specialty and [...]
Hint: Proposal would cause one practice in our sampling to lose $25,000 in a year. If your practice often complains about the limitations that the 1995 and 1997 E/M guidelines place on E/M coding, CMS may have delivered a gift [...]
Drop in agencies occurred in fraud-prone areas, MedPAC says. Law- and policymakers are basing their decisions on facts and figures the Medicare Payment Advisory Commission provides in its annual report to Congress. MedPAC's report contains these statistics about 2016: The [...]
