OtisMed Pleads Guilty to Distributing Adulterated Medical Devices.
OtisMed Corporation (OtisMed) and its former chief executive officer (CEO) recently pleaded guilty to intentionally distributing knee replacement surgery cutting…
CMS Offers Settlement Agreements to Resolve Patient Status Claims Denials.
The Centers for Medicare & Medicaid Services (CMS) is allowing hospitals to settle claims denied based on patient status for…
CMS Announces Pause in RAC Operations
The Centers for Medicare & Medicaid Services (CMS) announced that it will pause Medicare Recovery Audit Contractor (RAC) operations to…
OIG Reports on Part D Sponsors Voluntary Reporting of Fraud and Abuse Data.
The Department of Health and Human Services Office of Inspector General (OIG) recently reported on a study related to Medicare…
OIG Issues Report on Strengthening CMS Oversight of RACs.
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report urging the Centers for…
GAO Analyzes Inconsistencies of CMS Contractors.
The United States Government Accountability Office (GAO) recently released a report that analyzed inconsistencies of the Centers for Medicare &…
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…
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…
CMS Prepares to Launch the Recovery Audit Prepayment Reviews
The Centers for Medicare & Medicaid Services (CMS) recently launched the Recovery Audit Prepayment Review Demonstration on August 27, 2012,…
CMS Increases Contingency Fee for Medicaid RACs.
The Centers for Medicare & Medicaid Services (CMS) recently increased the maximum contingency fee that the Medicaid RACs can receive…
CMS Releases Proposed Rule on RACs for the Medicaid Program
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule outlining requirements and guidelines for the design…
CMS RAC Audits: Complex Review Issues
Although the Centers for Medicare and Medicaid Services (CMS) implemented the Recovery Audit Contractor (RAC) as a permanent program over a year…