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July 27, 2015

Recent Stories of Interest

From Report on Medicare Compliance - When it comes to fighting for reimbursement, sometimes hospitals have to act like a dog with a bone. That’s what WellSpan Health in York, Pa., is finding with some of its claims for bariatric surgery. They are being rejected even though the claims comply with national and local coverage determinations (NCDs and LCDs) for bariatric surgeries and the Medicare claims processing manual, says Becky Dennis, a nurse auditor at WellSpan. Read more

Health care organizations should brace for more administrative actions now that the… Read more

The HHS Office of Inspector General (OIG) is questioning hospitals on their… Read more

Some Stark walls may come tumbling down if CMS finalizes proposals 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.

July 10, 2015
Oncologist Sentenced to 45 Years for Fraud

Detroit-area oncologist Farid Fata was sentenced to 45 years in prison over medically unnecessary services. http://tinyurl.com/p8d6wqj

July 6, 2015
CMS Issues ICD-10 Guidance

Medicare auditors will go easy on claims submitted under Part B during the first year of ICD-10 implementation. http://tinyurl.com/nscbz5w

July 2, 2015
CMS Proposes Two-Midnight Rule Update

In OPPS rule, CMS more or less leaves the two-midnight rule intact, but shifts short-stay reviews to QIOs. http://tinyurl.com/ojb3xpf

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