$3 Million Settlement for Hospital Upcoding Allegations
Key Points: Whistleblower to receive nearly $1 million dollars. Improper bundling and upcoding described in whistleblower’s complaint. The Department of…
2021 OPPS and ASC Final Rule
The Centers for Medicare and Medicaid Services (CMS) published the Calendar Year (CY) 2021 Hospital Outpatient Prospective Payment System (OPPS)…
CMS Releases IPPS and LTCH Proposed Rule for FY 2020
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule that updates the Medicare payment policies and…
CMS Releases January 2019 Hospital OPPS Update
The Centers for Medicare & Medicaid Services (CMS) recently published a Medicare Learning Network (MLN) Matters article that outlines January…
OIG Issues Advisory Opinion on Charitable Pediatric Clinic Providing Cost-Sharing Waivers
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently issued an advisory opinion regarding a…
CMS Publishes OPPS and ASC Payment System Final Rule
The Centers for Medicare & Medicaid Services (CMS) published the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center…
CMS Issues Medicare Physician Fee Schedule Final Rule
The Centers for Medicare & Medicaid Services (CMS) published the final policy, payment, and quality provisions changes to the Medicare…
CMS Finalizes Payment and Policy Changes for Home Health Agencies
The Centers for Medicare & Medicaid Services (CMS) recently finalized payment and policy changes for Home Health Agencies (HHAs) and…
CMS Publishes Annual Adjustments to ALJ Hearings and Judicial Review Threshold Amounts
The Centers for Medicare & Medicaid Services (CMS) recently published the annual adjustments to the amount in controversy (AIC) threshold…
CMS Announces Changes to the Medicare Local Coverage Determination Process
The Centers for Medicare & Medicaid Services (CMS) recently announced changes to the Medicare Local Coverage Determination (LCD) process. Under…
CMS Issues Proposed Rule Updating the Physician Fee Schedule.
The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule updating the Medicare Physician Fee Schedule (MPFS).…
Looking Beyond the End of the Physician ICD-10-CM Coding Grace Period
Key Points ICD-10-CM Grace Period The one-year-long grace period for ICD-10-CM implementation ended on October 1, 2016. This provided the…