From Report on Medicare Compliance - Because there’s only one ICD-9 code for atrial fibrillation and it’s not a complication or comorbidity (CC), coders generally take it at face value. That will change when ICD-10 takes effect on Oct. 1, 2014, when physicians have the opportunity to describe the atrial fibrillation as paroxysmal, chronic or persistent. If it’s documented and coded as “persistent,” atrial fib is a CC, which may generate more MS-DRG reimbursement. Read more
From Report on Medicare Compliance - Henry Schein, Inc., the world’s largest purveyor of health care products and supplies to medical, dental and veterinary practices, agreed to pay $1.14 million to settle allegations that it violated the civil monetary penalty law applicable to kickbacks. The HHS Office of Inspector General had a bone to pick with Henry Schein’s Medical Privileges Program. Between Aug. 1, 2007, and Jan. 31, 2013, members of the program got points every time… Read more
From Report on Medicare Compliance - Sutter Health in California has agreed to pay $46 million to settle allegations that it overcharged for anesthesia in a case that breaks new ground in more ways than one. It was brought by the state Department of Insurance but originated with a whistleblower under the California Insurance Fraud Prevention Act (IFPA). The lawsuit alleged that Sutter Health, which includes 20 hospitals, improperly billed private insurers for anesthesia under revenue… Read more
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