From Report on Medicare Compliance - When hospitals pay physicians handsomely for services provided to an unprofitable line of business, the government may suspect a Stark violation because the arrangement seems commercially unreasonable. But that misrepresents the way things work at nonprofit hospitals, which routinely use profits from healthier departments to keep money-losers afloat, a former prosecutor says. Read more
From Report on Medicare Compliance - As it considered a merger with another health system, WellSpan Health in York, Pa., handed part of due diligence to the compliance department. Since compliance is accustomed to evaluating its own billing and documentation, why not do the same for a potential partner and save a bundle by keeping the work in-house? WellSpan’s nurse auditors, coders, chargemaster analysts and compliance specialists dug in, says Wendy Trout, director of corporate compliance. Read more
From Report on Medicare Compliance - Because they were burned last year when ICD-10 was delayed for a year, some hospitals may be gun shy about their investment in preparation for the Oct. 1, 2015, implementation of the new codes. But it looks more and more like ICD-10 will happen this fall, with CMS putting out resources for providers, payers and vendors, and end-to-end testing under way for a sample of volunteer Medicare fee-for-service providers. “I believe… Read more
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