Medicare requires that services provided/ordered must be authenticated by the author with either a hand written or electronic signature (stamps are not acceptable), although there are a few exceptions: (1) facsimiles of original written/electronic signatures are acceptable for the certification of terminal illness for hospice; (2) some orders do not need to be signed, for […]
A Detroit-area man plead guilty last week to conspiracy to commit health care fraud in an elaborate kickback operation to recruit Medicare beneficiaries to a clinic owned by his co-conspirators. According to the U.S. Departments of Justice (“DOJ”) and Health and Human Services (“HHS”), Melvin Young recruited Medicare beneficiaries to become patients at Ritecare, LLC, […]
The U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”) has revealed a new section to its website dedicated to the state Medicaid Fraud Control Units (“MCFUs”). MCFUs are intended “to investigate and prosecute fraud by Medicaid providers as well as patient abuse and neglect.” While MCFUs are administered by the states, […]
St. Vincent’s Hospital Manhattan, which filed for bankruptcy just two weeks ago with liabilities of over $1 billion, is putting one of its many buildings on the market this week, according to the New York Times. St. Vincent’s owns a number of properties in Greenwich Village. So far, it isn’t clear–at least publicly–what will happen […]
Centers for Medicare and Medicaid Services (“CMS”) reported yesterday that it realizes that fiscal intermediaries haven’t been providing sufficient detail on remittance advices (RAs) when recouping overpayments identified by RACs to allow providers to track and update their financial records. In response to that complaint, CMS issued CR 6870 and the corresponding MLN Matters 6870, […]
In February, we blogged on the recent changes in home health agency (HHA) accreditation. In April 2010, NGS issued its Medicare Monthly Review, and reiterated the same HHA accreditation and change of ownership provisions. Particularly, the article discusses the requirements a deactivated HHA must meet in order to reactivate its billing privileges. It also discusses […]
Meaningful use of electronic health records (EHR) technology has recently been expanded to include physicians providing services in outpatient facilities, according to the Continuing Extension Act of 2010. Initially, Congress had intended that only those physicians who purchased and implemented EHR technology would be eligible for the incentive payments, which would leave hospital-based physicians without […]
The Continuing Extension Act of 2010 was signed into law on April 15. This law reinstates the March 31 Medicare Physician Fee Schedule (Fee Schedule) rates for physicians, postponing, yet again, the anticipated-21.3% cut. The zero percent (0%) update to the Fee Schedule has been extended to May 31 will apply retroactively to claims that […]
Yesterday, the U.S. House of Representatives proposed a bill that ups the ante on Medicare fraud. The bill, the Medicare Fraud Enforcement and Prevention Act, will double prison sentences from 5 to 10 years and fines from $25,000 to $50,000 for Medicare fraud-related crimes, and creates a new crime for illegally distributing patients’ Medicare and […]
The New York state attorney general’s office announced yesterday that it recovered more than $283 million and obtained a record of 148 Medicaid fraud convictions in 2009. This information is detailed in an Annual Report submitted to the Secretary of the U.S. Department of Health and Human Services. The report highlights the cases, settlements, and […]
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