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September 1, 2014

Recent Stories of Interest

From Report on Medicare Compliance - Hospitals reportedly have been waiting much longer to get an answer to Medicare beneficiary appeals of discharge decisions since CMS overhauled the quality improvement organization (QIO) program. The delay in deciding whether beneficiaries are entitled to have their stays extended may be hard on hospitals and/or beneficiaries financially and could interfere with the shift to post-acute care, experts say. Although CMS says it’s addressing the problem, which began in early August, it may not bode well for the medical necessity reviews, MS-DRG validations and other tasks that will be performed by the two QIOs that are now hearing beneficiary appeals, experts say. Read more

Hospital manager Dave Reynolds was having an exasperating day. His wife, a… Read more

If hospitals suddenly find that more physicians embrace compliance and documentation improvement,… Read more

As Medicare auditors crack down on billing for sleep studies, some hospitals… 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.

September 2, 2014
Surgeon, Spine Device Manufacturer Settle Kickback Case for $2.6M

Surgeon, spine device manufacturer settle kickback case for $2.6 million. www.justice.gov

September 2, 2014
CMS Offers Hospitals Fast Route to Settling Appeals of Inpatient Denials

CMS offers hospitals fast route to settling appeals of inpatient denials. http://tinyurl.com/lojmp4p

August 25, 2014
OIG Releases Advisory Opinion on a Preferred Hospital Network Used in 'Medigap' Policies

OIG posted an advisory opinion on a preferred hospital network used in "Medigap" policies. http://go.usa.gov/mXKV

Updated Regularly

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