Make sure your compliance plan is resolving complaints before they head to litigation. Need a good reason to punch up your compliance plan? The feds just gave you more than a billion of them. For the fiscal year ended on [...]
Caution: The 2023 FCA settlement numbers may shock you. Per usual, the feds are off and running in 2024 with several million dollar settlements — many targeting clinicians. Backtrack: Though 2024 is looking like it’s going to be a banner [...]
Though 2024 is looking like it’s going to be a banner year for Medicare enforcement, the 2023 statistics show last year was one for the ages, according to the Department of Justice. For the fiscal year 2024, which ended on [...]
If you’re leaning toward pausing your vaccination requirement process, be ready to crank it back up on a dime, legal experts stress. Medicare’s sweeping COVID vaccination rule is now on ice, and that’s leaving uncertain home health and hospice agencies [...]
Medicare needs to examine its requirements, experts charge. The latest results from the Targeted Probe and Educate medical review program indicate you are virtually doomed if you land on TPE review. Why? Out of the 122 home health agencies that [...]
You saw how three ophthalmologists would fare under the proposed E/M payment changes —now check out what the impact would be to three optometrists whose data we sampled. Using the current E/M payment levels and comparing them to the proposed [...]
Encryption fails bring massive penalties, OCR case shows The HIPAA Security Rule requires covered entities (CEs) to assess, analyze, and manage practice risks to safeguard patient and provider data. Taking a lax approach to these federally-mandated security policies and procedures [...]
Keep long-term impact of expanded Level 1 edits in mind, experts urge. Chances are you need to shore up your cost reporting practices to avoid failing newly announced Level 1 edits. So indicates the Centers for Medicare & Medicaid Services' [...]
Line 3 Employee Benefits - missing from 13.80% of reports in 2016 (385 reports) Line 4 Administrative & General - missing from 0.29% of reports (8) Line 5 Plant Operations and Maintenance - missing from 45.16% of reports (1,260) Line [...]
Same code applies to porencepahly, both acquired and developmental. When your surgeon documents a diagnosis of cerebral cyst, there isn’t a chance you can miss the diagnosis code. You have just a single code that applies to cyst(s) of all [...]
