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November 3, 2014

Recent Stories of Interest

From Report on Medicare Compliance - Semantics aside, CMS has essentially extended the deadline for the 68% settlement offer on claims denied for the wrong site of service. Hospitals that ask CMS for a list of claim denials that may qualify for Medicare partial payment buy more time to decide whether to accept 68% of the net Medicare amount of claims for inpatient admissions that were denied because they should have been outpatient/observation services in exchange for dropping their appeals (RMC 10/13/14, p. 1, 9/15/14, p. 1, 9/22/14, p. 6). Read more

How board members respond to reports of a compliance issue at their… Read more

An upstate New York hospital has agreed to pay $3.373 million to… Read more

While hospitals fend off claim denials in core compliance risk areas, they… 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.

October 31, 2014
OIG Releases 2015 Work Plan

The OIG released its 2015 Work Plan, a roadmap of audits and investigations for the fiscal year. http://tinyurl.com/3ucv5sq

October 31, 2014
Dignity Health Pays $37M to Settle False Claims Allegations

Dignity Health pays $37 million to settle false claims allegations that inpatient admissions should have been billed as outpatient services. http://tinyurl.com/p9b53x5

October 23, 2014
CMS Indirectly Extends 68% Deadline

CMS indirectly extended the 68% settlement process deadline for hospitals that request a list of potential eligible claims. http://tinyurl.com/ordxv2p

Updated Regularly

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