Toxic effect of alcohol (980)

The Senior Medicare Patrol’s recoveries are down, but it’s keeping up the pressure on the hospice industry. Hospices have been feeling scrutiny from regulators for some time, but now it’s coming from a new source — your patients’ peers. “In [...]

In 2020, the Senior Medicare Patrol fraud-fighting program netted about half its $16.8 million in recoveries from a home health investigation (see story, p. 190). For 2021, there’s no mention of home health in the SMP annual report at all, [...]

For home health agencies that furnish outpatient Part B therapy in the home, therapy caps are going up. The 2018 therapy cap for speech-language pathology services and physical therapy services (combined) is $2,010, notes the American Speech Language Hearing Association. [...]

Limit wasted drug policy to only single use vials and containers. The beginning of the New Year marks the dawn of the JW (Drug amount discarded/not administered to any patient) modifier mandate. Medicare has a clear directive on the essential [...]

Check with the QIOs for your denied claims status before you take to appeals. In a yet another twist of events related to the implementation of two-midnight rule, CMS recently asked the Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIOs) [...]

But don’t overlook it completely, CMS says. While CMS won’t give in fully to recommendations that it rescind the two-midnight rule, the agency is allowing physicians a bit of leeway. Get the scoop on the changes and what they mean [...]

Medical predictability of adverse event could be the decider of patient status. The Centers for Medicare & Medicaid Services (CMS) made revisions to the over two-midnight rule, as a part of final OPPS rule for 2016, in the Federal Register [...]

CMS to allow exceptions on a case to case basis, with proven medical necessity. It’s time to celebrate the new year with your newfound autonomy on deciding the patient’s status, thanks to the revision CMS made in the Federal Register [...]

The following House bills were introduced: H.R. 960. A bill to amend part C of title XVIII of the Social Security Act to consolidate and restate the federal laws relating to the social health maintenance organization projects, to make such [...]

Your psychiatrist will arrive at a diagnosis of obsessive compulsive disorder based on a complete history and an evaluation of the person's signs and symptoms. This service would include a complete mental status examination, a complete psychiatric and medical history [...]