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21 Dec 2018, 10:43 am
Audits of Telehealth Services are Increasing. [read post]
30 Aug 2013, 12:09 pm
Many physicians I have spoken with over the years mistakenly believe that if they undercode their services, they are reducing their risk of being audited. [read post]
17 Sep 2014, 9:10 pm
OIG’s Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Andrea Treese Berlin and Geoffrey Hymans, collaborated to achieve this settlement. [read post]
26 Sep 2022, 3:46 am
Despite the fact that physician practice profit margins are declining, it is becoming more expensive each year for a physician to run a practice. [read post]
3 Feb 2014, 7:28 am
Much like the previous ODFs, interested parties will have an opportunity to ask questions regarding inpatient hospital admission, medical review criteria, physician orders and physician certification. [read post]
17 Apr 2014, 10:00 am
Recovery audit contractors (RACs) typically conduct post-payment reviews of inpatient hospital admissions with dates of admission in which the one year rebilling deadline has already elapsed. [read post]
14 May 2012, 8:08 am
The OIG recommends that CMS adjust the estimated number of E/M services within cardiovascular global surgery fees to reflect the actual number of E/M services being provided to beneficiaries, or use the results of this audit during the annual update of the physician fee schedule. [read post]
10 Jan 2013, 8:06 am
They also represent physicians, medical groups, nursing homes, home health agencies, pharmacies, hospitals and other healthcare providers and institutions in Medicare and Medicaid investigations, audits, recovery actions and termination from the Medicare or Medicaid Program.For more information please visit our website at www.TheHealthLawFirm.com or call (407) 331-6620 or (850) 439-1001.Sound Off.What do you think of this case? [read post]
23 Jul 2009, 5:56 am
Additionally, this article will address anticipated Medicare audit activity for diagnostic imaging providers in connection with the Medicare Recovery Audit Contractor Program. [read post]
1 Nov 2012, 3:31 pm
Since the inception of the RAC Demonstration Program and implementation of the permanent RAC Program, the attorneys of The Health Law Partners, P.C. have provided legal counsel to numerous hospitals, inpatient rehabilitation facilities, physicians, and other providers faced with RAC payment audits and denials. [read post]
4 Jun 2019, 8:02 am
If you are a provider who is being investigated for kickbacks, or who has a business interest in a lab/imaging facility or other practice, be sure to advise your attorney on the details of your business structure before you receive a request for an audit. [read post]
16 Jun 2010, 2:59 am
According to the hand hygiene compliance audits conducted in January and February, physicians were the worst at washing their hands. [read post]
15 Oct 2016, 8:00 am
Mainstream managed care provides hospital care, physician services, dental services, pharmacy benefits, and many others. [read post]
30 Sep 2019, 2:08 pm
” If you have not already done so, your home health agency needs to periodically conduct internal audits and reviews to better ensure that physicians, nurse practitioners, therapists and staff [read post]
16 Feb 2017, 3:01 pm
MHS’ failure to follow through to implement the controls required by its policies and audit and enforce compliance with HIPAA and its HIPAA policies was a costly mistake. [read post]
25 Sep 2009, 12:56 pm
Some notable points include: - Limiting physician referrals only to permit hospitals that meet certain exemption requirements, which would be more stringent than the current Medicare requirements; - Establishing a process to update HIPAA standards periodically; - Increasing transparency in the physician-manufacturer relationship involving payments and transfers of value and physician ownership or investment interests in manufacturers; - Including in the in-office ancillary… [read post]
15 Dec 2015, 4:23 am
On Friday I quoted blogger and principal of Health Strategy Associates, Joe Paduda, about physician's reticence to complete paperwork.Paduda opined that physicians would be loath to move claims from general health to work comp because of the extra paper work, stating, "documentation that is perceived by physicians as irrelevant to patient care is the discontent of doctors - seems to me that's the definition of workers' comp. [read post]
8 Jan 2024, 10:00 am
A prior audit, issued in April 2022, found that the Department of Health’s (DOH) eMedNY claims processing system edits designed to prevent payments for services with an inactive OPRA provider were flawed, and Medicaid made $965 million in payments for 2.3 million OPRA services by physicians and professionals who were no longer actively enrolled in Medicaid on the service date. [read post]
8 Jan 2024, 10:00 am
A prior audit, issued in April 2022, found that the Department of Health’s (DOH) eMedNY claims processing system edits designed to prevent payments for services with an inactive OPRA provider were flawed, and Medicaid made $965 million in payments for 2.3 million OPRA services by physicians and professionals who were no longer actively enrolled in Medicaid on the service date. [read post]
25 Mar 2019, 1:09 pm
One of those questions specifically requires OIG to explain whether it has “conducted a detailed review and audit of the CMS sunshine database to determine whether PODs are reporting physician ownership or investment interest. [read post]
