Attorney General Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius recently announced the creation of a new interagency effort, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), to combat Medicare fraud. Holder and Sebelius also announced the expansion of Strike Force team operations to Detroit and Houston. Medicare Fraud Strike Forces, […]
Health care fraud enforcement has restored funds to the trust funds and protected our citizens from health care fraud schemes. The Department is committed to the ongoing success of the HCFAC program and will continue to marshal its resources, including those provided by the HCFAC program and its own discretionary funds, to ensure that federal health care dollars are properly expended. We are committed to prosecuting fraud and abuse in the Medicare and Medicaid programs and restoring the recovered proceeds to these programs. We look forward to working with Congress and this Committee in particular, through these efforts, to make health care available to those who have no such safety net.
In order to receive stimulus funds from the American Recovery and Reinvestment Act (ARRA), healthcare providers must not only purchase Electronic Health Record system but are also required to put them to “meaningful use.” Guest author Lawrence Kerr, an upstate New York surgeon who, with his pediatrician wife, last year developed an online wound care […]
An urgent message has been released by The National Association for Home Care and Hospice (NAHC) and the Home Care and Hospice Financial Managers Association (HHFMA). The mistaken notion since PPS began that home care agency cost reports are less important than they once were may be creating a serious problem.
Keep an eye on the progress of Senate Bill 1959, introduced on October 28 by Senator Ted Kaufman (D-Del.), (along with co-sponsoring Senators Patrick Leahy, Arlen Specter, Herb Kohl, Chuck Schumer, and Amy Klobuchar), especially if you operate a Medicare home care agency in Miami-Dade, Houston, Detroit or Los Angeles. The Health Care Fraud Enforcement […]
It has just become far more likely that Medicare will take disputed money while healthcare providers pursue payment denial appeals instead of waiting to collect it until a decision has been reached at the end of the process. On September 16, 2009, CMS published a Final Rule implementing Section 935 of the Medicare Prescription Drug, […]
On August 19, 2009, the Department of Health and Human Services (HHS) issued an interim final rule entitled “Breach Notification for Unsecured Protected Health Information.” This rule describes how healthcare providers must notify patients when the security of their protected health information has been breached. Providers must comply with these new requirements beginning on September […]
This is the fourth and last in our series based on our July interview with NAHC attorney Denise Bonn and her presentation to the NAHC Financial Managers meeting.
Abt Associates has released its annual report designed to justify CMS’s contention that home care agencies have been gradually inflating OASIS assessments since PPS began, resulting in artificially higher payments that do not accurately reflect a patient’s level of service need. The "case-mix creep" theory convined MedPAC to recommend four consecutive years of rate cuts and raised pressure on clinical software developers, OASIS checking services and OASIS trainers to help clinicians become ever more accurate and consistent with their assessments. The report was just released but we offer some quick reactions to its highlights and invite readers to examine it more closely.
ICD-10 Fact Sheet available for download.
