Post-COVID fallout continues to be a problem. If you need a reminder of why your practice may be seeing unprecedented scrutiny, look no further than the HHS Office of Inspector General’s (OIG’s) latest enforcement opus. Background: In the OIG’s Semiannual [...]
Watch out for tight turnaround. Since a big chunk of your Special Focus Program score will rely on survey results, it’s important that they are accurate. That may be hard to assure given surveyor variability and other issues, but one [...]
Bad news: The oversight program for poor performing hospices is still proceeding with plenty of flaws. Hospices will have a bit of breathing room after all, before they tackle the Special Focus Program. In a Nov. 14 hospice forum, Centers [...]
Courts aren’t afraid to levy big CMPs for ‘willful violations.’ A Virginia home care agency is learning the hard way that it can’t skirt overtime laws. The U.S. District Court for the Eastern District of Virginia has directed 1st Adult [...]
Caution: AKS issues remain an OIG sticking point. With the pandemic largely in the rearview mirror, you may be revising your policies and heaving a sigh of relief. But don’t get too comfortable — federal enforcers aren’t taking any breaks [...]
Plus: MAC needs to collect all cap overages, watchdog agency highlights. Home health and hospice agencies aren’t playing a starring role in the HHS Office of Inspector General’s latest Semiannual Report to Congress, but they do get some less-than-desirable attention. [...]
Get to know how these new CMS proposed rules might affect your practice. Fee schedule changes to most evaluation and management (E/M) services have been relatively safe from CMS intervention over the past few years. As for 2019, however, it’s [...]
Hint: Proposal causes one pulmonary practice in our sample to lose $93,000 in one year. Pulmonology practices have been able to rest easy during the past few years’ worth of fee schedule changes, but this year may have thrown a [...]
Hint: You’ll have lots more urethral stricture options. The next round of ICD-10-CM changes won’t go into effect until Oct. 1, but CMS has released information on new, revised, and deleted codes for the next year. Changes applicable to urology [...]
Therapy episodes would get reimbursed less. If your claims are dominated by episodes with high therapy, no recent hospital stays, or patients with behavioral health conditions such as schizophrenia, bipolar disorder or drug addiction, Medicare’s draft for HH PPS payment [...]
