CMS Publishes FY 2013 Hospital OPPS and ASC Final Rule
The Centers for Medicare & Medicaid Services (CMS) recently released the finalized Hospital Outpatient and Prospective Payment System (OPPS) and…
CMS Releases FAQs for the Billing under the Three- and One-Day Payment Windows
The Centers for Medicare & Medicaid Services (CMS) recently published Frequently Asked Questions (FAQs) regarding the three-day and one-day payment…
HHS Spends Over $1 Billion in Improper Payments to Skilled Nursing Facilities
The Department of Health and Human Services Office of Inspector General (OIG) reported results from a review of 499 Medicare…
GAO Reports on Recent Increase in Self-Referrals for Advanced Imaging Services
The Government Accountability Office (GAO) recently conducted a study on the growth in referrals and expenditures for magnetic resonance imaging…
OIG Finds Excluded Individuals Employed by Medicaid Managed Care Entities
The Department of Health and Human Services Office of Inspector General (OIG) released a report concerning excluded individuals in Medicaid…
GAO Issues Report on Health Care Fraud and Abuse Investigations
The Government Accountability Office (GAO) recently issued a report on providers involved in Medicare, Medicaid, and Children’s Health Insurance Program…
Medicare Fraud Strike Force Charges 91 Individuals for Criminal Activities for Falsely Billing Medicare for $430 Million
Attorney General Eric Holder recently commended the Medicare Fraud Strike Force for their action against 91 individuals in seven states…
CMS Starts New Initiative to Reduce Avoidable Hospitalizations for Nursing Home Residents
The Centers for Medicare & Medicaid Services (CMS) recently launched the “Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents.”…
Massachusetts Provider Enters into a $1.5 Million Settlement with HHS for HIPAA Violations
Massachusetts Eye and Ear Infirmary and Massachusetts Eye and Ear Associates Incorporated (MEEI) settled with the Department of Health and…
New York Downtown Hospital Settles Allegations of Medicaid Fraud for $13.4 Million
The New York Attorney General’s Office recently settled with New York Downtown Hospital (NY Downtown Hospital) for $13.4 million following…
HHS Publishes Final Rule for a Unique Health Plan Identifier and to Delay ICD-10 Implementation.
The Department of Health and Human Services (HHS) recently published a final rule that will establish a unique health plan…
CMS Releases IPPS 2013 Final Rule
The Centers for Medicare & Medicaid Services (CMS) released the final rule on the hospital Inpatient Prospective Patient System (IPPS)…