Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announced Wednesday that a nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in charges against 91 defendants, including doctors, nurses, and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing.
HHS Secretary Kathleen Sebelius revealed on February 17 that the H.E.A.T. Strike Force effort has returned $6.80 for every taxpayer dollar spent. Two new cities will open H.E.A.T. offices this month.
Have you spoken with your software vendor yet about their plans for the HIPAA 5010 claims transaction sets? Testing begins in January, with implementation one year later. After that, CMS claims, ICD-10 will arrive on time in 2013, and it will be obligatory for all HIPAA covered entities, not just those that submit claims to Medicare and Medicaid.
If home health care providers sometimes feel that government agencies treat the industry like a pre-ball Cinderella when it comes to payment rates, a new report from the Office of Inspector General (OIG) will not make them feel any better. Though CMS continues to look for reasons to reduce payment rates to home care agencies, [...]
Amidst all the news this month about PPS rate cuts, do not forget your regular opportunity to hear directly from CMS. Here is the phone number and code for their August 25 Open Door Forum.
Though the deadline has been pushed back a few months, RHHIs will soon deny payment for home health care claims if the physician authorizing Medicare services was not registered in the Medicare Provider Enrollment, Chain and Ownership System ( PECOS) or opted out of Medicare by the date services began. Wouldn’t it be handy if your referral intake software included a direct link to the PECOS database? We have found two such services so far.
At the top of three regulatory stories this week is one that appeared on the news wires just before this issue went to press. The Federal H.E.A.T. strike force, a joint effort of HHS, the FBI, the federal Department of Justice and the DEA, arrested 94 people so far in Miami, Baton Rouge, Detroit and Brooklyn. The number is expected to grow as more arrests are announced throughout the weekend.
In a related announcement, Secretary Kathleen Sebelius said that health care fraud fighters in the state of Florida will now have additional funding to help find potential fraud and abuse in the state’s Medicaid program through use of Medicaid claims data.
President Barack Obama will nominate Donald Berwick, M.D., president and CEO at Boston’s Institute for Healthcare Improvement, as his new CMS administrator. Charlene Frizzera, COO of CMS and acting administrator since January 2009, will remain COO once Berwick is approved.
PECOS Down Due to scheduled maintenance, Internet-based Provider Enrollment, Chain and Ownership System (PECOS) will be unavailable from Monday, March 29, 2010 through Monday, April 5, 2010. Internet-based PECOS allows physicians, non-physician practitioners, providers, and other suppliers (except suppliers of durable medical equipment, prosthetics, orthotics, and supplies [DMEPOS]) to enroll or make a change to [...]
During the recent HIMSS meeting, U.S. Surgeon General Regina Benamin delivered an address that outlined her vision for using Electronic Health Records to improve the nation’s health. We received permission to reprint it verbatim.
