Compliance
RACs Deny Admissions for Inpatient-Only Procedures; CMS Says There’s More to ItFrom Report on Medicare Compliance - Some admissions for procedures on the Medicare inpatient-only list are being rejected as medically unnecessary by recovery audit contractors (RACs). That may seem like an oxymoron because Medicare doesn’t pay for procedures on the list unless they are performed on an inpatient basis. Read more
KPMG Official Describes Early Audit Results, What to Expect If You’re SelectedFrom Report on Patient Privacy - In his first public comments since his consulting firm officially “exited the field” after wrapping up site visits for the initial 20 compliance audits, the top HIPAA official at KPMG says covered entities (CEs) are failing to complete basic tasks, such as conducting a risk analysis and giving out a notice of private practices. Michael Ebert, national HIPAA services leader for KPMG, which is performing the audits for OCR, also said… Read more
Pervasive HIPAA Failings Net Surgeons the First OCR Sanctions Against PhysiciansFrom Report on Patient Privacy - From the look of things, the small cardiac surgery practice in Phoenix completely ignored most of the privacy requirements from the day they went into effect in 2003, and later did the same when the security rule came online two years later, until one winter’s day in 2009 when the Office for Civil Rights came knocking. What first got OCR’s attention was a complaint alleging that Phoenix Cardiac Surgery was posting… Read more
Compliance Blog
By Francie Fernald - May 17, 2012
FY 2013 is the first year hospitals will deal with the reimbursement impact of the Hospital Value-Based Purchasing (Hospital VBP) program. CMS will compare a hospital’s score on certain measures to a baseline standard and calculate an incentive payment for hospitals that meet or exceed the baseline...
By Nina Youngstrom - May 7, 2012
HHS Inspector General Dan Levinson emphasized the importance of the compliance officer’s independence from internal counsel during remarks April 30 at the Health Care Compliance Assn.’s annual Compliance Institute. As health care organizations tackle complex issues, there should be some separation...
By Francie Fernald - April 26, 2012
No doubt you are aware that CMS has posted the proposed FY 2013 Inpatient Prospective Payment Rule for review and comment (comments are due by June 25; Federal Register publication is scheduled for May 11).
Perhaps the best news is that this year the scramble to update systems with new ICD-9-CM...
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