Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have noticed that the feds seem to be ramping up their midyear fraud enforcement activity. In fact, June was a particularly busy month with more than 35 civil [...]
Prescription fraud, E/M upcoding, and more factor in latest settlements. You might have noticed that the feds seem to be ramping up their midyear fraud enforcement activity. In fact, June was a particularly busy month with more than 35 civil [...]
The Civil Money Penalties that home health agencies are now subject to can pack a serious punch, a new Centers for Medicare & Medicaid Services letter to State Survey Agency Directors shows. And a recent inflation update makes the punch [...]
Beware: Other alternative sanctions still can shut you down for noncompliance. Home health agencies hoping to see the CoPs delayed once again were disappointed with a Medicare announcement to the contrary, but it's not all bad news. In a letter [...]
Survey citations can shut your doors in a heartbeat. Whether it’s compliance with the current Home Health Conditions of Participation now or with new requirements starting Jan. 13, it’s important to keep on top of your shifting regulatory requirements. Why? [...]
DOJ outlines atypical settlement. Whistleblower lawsuits aren’t threats to only freestanding, for-profit home health agencies. So suggests a recently announced fraud settlement with the University of Pennsylvania. Penn, on behalf of University of Pennsylvania Health System, will pay the relatively [...]
Question: A patient with carcinoma S/P radiation and chemo has subsequent dysphagia and stenosis. How do I report the dysphagia as I see many options to report the diagnosis? New Hampshire Subscriber Answer: If your surgeon has not specifically mentioned in the [...]
Question: A patient with carcinoma S/P radiation and chemo has subsequent dysphagia and stenosis. How do I report the dysphagia as I see many options to report the diagnosis? New Hampshire Subscriber Answer: If your surgeon has not specifically mentioned in the [...]
Identify when you need to attach modifier 25 to an E/M service. These days, it isn’t a matter of if you will face Recovery Audit Contractor (RAC) scrutiny, but rather when. So now is the time to shore up your [...]
Plus: Hydration therapy goes under the microscope. You may not have seen a Recovery Audit Contractor (RAC) at your office lately, but that doesn’t mean they aren’t scrutinizing claims nationwide. The RACs’ latest targets could lie in claims for E/M [...]
