Centers for Medicare and Medicaid Services (CMS) noted that consignment closets (also known as stock and bill arrangements) have not complied with durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) supplier standards. As a result, CMS issued a Change Request (CR) affecting physicians and DMEPOS suppliers, which allows for consignment…
The Recovery Audit Contractor (“RAC”) for region D, HealthDataInsights, Inc. recently published its RAC website, and published its first list of approved RAC audit issues for complex coding reviews. Pursuant to the recently-published CMS RAC Review Phase In Strategy, complex reviews regarding DRG validation and coding errors were scheduled to…
FTC postponed Red Flags. As many entities have been scrambling to get their anti-identity theft programs in place by August 1, the Federal Trade Commission (FTC) announced that it would be pushing back enforcement of the Red Flags Rule until November 1. The purpose of this is to continue to…
The Affordable Health Choices Act (Act) has been hotly contested by many Republicans, some Democrats, and now, is being put in place by Congressional Budget Office (CBO). The CBO is the final authority when it comes to the cost of legislation and it announced that the Act is not “budget…
According to the 2010 Proposed Physician Fee Schedule (PPFS), as of January 1, 2012, the Center for Medicare and Medicaid Services (CMS) proposes that Medicare payment be made only for the technical component (TC) of advanced diagnostic imaging services to suppliers who have met the accreditation requirements set forth by…
House Democrats released the long-awaited healthcare bill today. In its 1018 pages, it describes its 10-year, $1 trillion venture that includes the highly controversial government insurance plan. As Democrats have publicized, this bill will greatly expand healthcare insurance coverage to Americans without insurance and, at the same time, slow the…
Wednesday, Michigan’s Attorney General–Michael Cox–alongside Republican legislators supported a bill being drafted by the Michigan legislature that would create a Michigan Office of Medicaid Inspector General (OMIG). This office would convert the already-in-place Medicaid Fraud Control Unit to an office that audits Medicaid activities and helps detect and prevent Medicaid…
The August 1st Red Flags start date is quickly approaching and many creditors (yes, that means you, doctors) are preparing themselves for the new regulations. For those entities that have not drawn up their Red Flags programs yet, there is still time and the Federal Trade Commission (FTC) has provided…
If you’re a physician, the Centers for Medicare and Medicaid Services (CMS) Proposed Physician Fee Schedule for 2010 affects you. As a matter of fact, according to the proposed rule, Medicare will cut spending on physician services by 21.5% beginning in January 2010. The finalized fee schedule will be released…
An Office of Inspector General (OIG) Advisory Opinion, OIG Advisory Opinion No. 09-06, was released addressing the issue of whether or not “expanding an existing program that provides free oral nutritional supplements to malnourished end-stage renal disease patients who are on dialysis” would violate the civil monetary penalty provision or…