Don't miss these two increases to Medicare MUEs. Want to get your 2025 off to a good start? Take a look at these recent important changes to Medicare coding edits, frequency edits, and Proprietary Laboratory Analyses (PLA) codes, and stay [...]
Labs, X-rays could be part of ED E/M. Arthrocentesis, commonly known as joint drainage or joint injection, is routinely performed in emergency departments (EDs). This procedure helps diagnose various joint-related conditions and deliver therapeutic treatments. Sometimes, the best way to [...]
OIG excludes nearly 1,800 from federal programs in period from October through March. A complicated Medicare home health scam is front and center once again, this time in the HHS Office of Inspector General’s new greatest hits report. “To hold [...]
Question: We have a 17-year-old patient recently diagnosed with diabetes. The notes say type 2, but should I query the provider to clarify, since this patient is a juvenile? Indiana Subscriber Answer: It’s more than likely your provider did not make a [...]
In one case, a criminal deposited fraudulent checks after pleading guilty. If you’re wondering why states are cracking down on Medicaid fraud, look no further than a case in Minnesota. Attorney General Keith Ellison has charged five persons linked to [...]
Plus: Intermountain snaps up Advent HH. A seven-state home health and hospice chain is partnering more closely with a Chicago-area health system. Residential Home Health and Hospice is now acting as the preferred provider of hospice services at Northwest Community [...]
Plus: PE-backed firms make purchases. Two chains have had success targeting acquisitions from senior living-focused firms. In Tennessee, Addus HomeCare Corp. has agreed to acquire the entities comprising Tennessee Quality Care, a provider of home health, hospice, and private duty [...]
Beware triggering unexpected dangers when compensating your medical directors. Does the OIG have you in their sights? Read on to see how you can avoid being their next target. What the Law Says: The Anti-Kickback Statute (AKS) is a criminal [...]
Plus: One state claimed more than $50 million in unallowable PCA services, OIG report charges. Both federal and state authorities are getting ever-more-serious about combatting fraud in Medicaid home health programs, as shown by a flurry of enforcement activity in [...]
On Feb. 8, 2023, the Federal Bureau of Investigation (FBI) and Cybersecurity and Infrastructure Security Agency (CISA) released a joint cybersecurity advisory (CSA) responding to the ESXiArgs ransomware campaign. The CSA warns that threat actors look to exploit vulnerabilities in VMware [...]
