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May 25, 2015

Recent Stories of Interest

From Report on Medicare Compliance - CMS said on May 21 that it’s expanding “probe and educate” reviews to home health claims. Medicare auditors will do prepayment reviews to evaluate compliance with physician certification requirements, and documentation requests are expected to hit home health providers around Oct. 1. It’s the first time CMS has used the probe and educate strategy outside the two-midnight rule. That also will continue now that Medicare administrative contractors have marching orders to use probe and educate to assess hospital compliance with the two-midnight rule through Sept. 30, consistent with the 2015 Medicare Access and CHIP Reauthorization Act (RMC 5/11/15, p. 8; 4/20/15, p. 1). Read more

In a false claims case set in motion by its compliance officer,… Read more

When the dust settles and auditors are unleashed again on inpatient admissions,… Read more

Emergency room technician Kathryn Knott was fired from Lansdale Hospital-Abingdon Health in… Read more

From the Editor

Welcome to your Report on Medicare Compliance subscriber-only Web page

Be sure to visit often, for PDFs of issues, archives of articles, links to government documents and more!

Please e-mail me with your comments on the last issue of Report on Medicare Compliance, story ideas for future issues, or any other suggestions you have that can make the newsletter more useful for you.

May 27, 2015
OIG Says Cox Medical Overcharged for Kwashiorkor

OIG said Cox Medical Center overcharged Medicare for inpatient claims with kwashiorkor. http://go.usa.gov/39Azk

May 21, 2015
OIG Reviews St. Anthony's Medical Center

OIG posted a Medicare compliance review of Saint Anthony's Medical Center. http://go.usa.gov/39xTz

May 8, 2015
OIG: Use of Wrong Place-of-Service Codes Costly

OIG said that use of incorrect place-of-service codes has cost Medicare millions. http://go.usa.gov/3kqQm

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