The financial penalties that Medicare imposes on hospitals with high rates of patient readmissions are too harsh for hospitals serving the poor and should be changed, according to a congressional advisory agency. Since last fall, Medicare has been reducing its...
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Regulations
OIG: CMS Should Establish Transfer Payment Policy for Eary Discharges to Hospice Care
The OIG recently issued a report, found at www.kslaw.com, concerning the potential financial impact to Medicare Part A if CMS established a hospital transfer payment policy for early discharges to hospice care. The OIG explained that it undertook this review because...
CMS Touts Dwindling Number of DME Companies
The Centers for Medicare & Medicaid Services has removed 14,663 healthcare providers and suppliers from the Medicare program in the last two years, the agency announced Thursday. The figure more than doubles the number of removals from the prior two-year period. The...
RACs push back against audit improvement bills
An advocacy group for independent Medicare auditors has sharply criticized two bills that would put new controls on Recovery Audit Contractors. The Medicare Audit Improvement Act of 2013 was introduced in the House of Representatives in March. A Senate version of the...
Small Companies Look to Early Insurance Renewal
Small companies seeking to ward off key health-law provisions—at least for a while—are weighing offers by some large insurers to hit the reset button on their yearlong health plan service contracts in December. Many contracts normally restart at the beginning of...
Legislation to Improve CMS RAC Program Introduced in U.S. Senate
An identical version of the Medicare Audit Improvement Act (MAIA), reported on in the March 25, 2013 issue of Health Headlines when it was introduced in the House, has now been introduced in the Senate by Senator Roy Blunt (R-MO). As explained in the March 25th Health...
VGM calls on providers to testify at small business hearing
The Small Business Administration (SBA) plans to conduct a field hearing in which providers can voice their concerns about the negative impact of competitive bidding and Medicare audits on small businesses, according to a bulletin from the VGM Group. To testify at...
Senate Takes up Bill to Improve Medicare Audits and Address RAC Concerns
A new Senate bill addresses provider concerns over the Medicare audit process, including the role of Recovery Audit Contractors. The House is also considering a version of the “Medicare Audit Improvement Act of 2013,” which lawmakers originally introduced in October...
CMS Issues more In-Depth Survey Guidelines to Reduce Readmissions
The Centers for Medicare & Medicaid Services has revised the provider certification manual for hospitals, giving more in-depth guidelines around discharge planning. The goal is for hospitals to reduce readmissions by partnering with post-acute providers. The...
Did CMS Break Rules to Rig Bid Numbers?
Anybody who is paying any attention to the Medicare competitive bidding program understands that the program is fatally flawed. We all know that just about every qualified expert in the field of auction design has agreed that the program breaks just about every rule...
OIG Releases Updated Provider Self Disclosure Protocol
The Office of Inspector General ("OIG") of the Department of Health and Human Services ("HHS") has issued a revised version of its Provider Self-Disclosure Protocol ("Updated SDP"), dated April 17, 2013, which established a process for health care providers to...
Industry Casts Further Doubt on Bid Process
H.R. 1717 remains the HME industry’s No. 1 priority, but with time running out, stakeholders are again pressing for a delay in the July 1 start date of Round 2 of competitive bidding. The basis for that delay: a growing list of contract suppliers that appear to fail...