Lung cancer is the leading cause of cancer deaths in the United States and third in overall cancer incidence according to 2013 National Cancer Institute statistics. Fortunately, newly approved preventive…
Are You Familiar With the New CMS Payment Model?
The new CMS payment model ties reimbursement to value instead of volume. The focus is on developing a payment method based on quality and improvement of the delivery of care.…
Are You Aware of the New OSHA Reporting Requirements?
All employers under Federal OSHA jurisdiction are required to report any work-related fatality within 8 hours. As of January 1, 2015, all employers are also required to report any work…
$22 M of Potential Fraud, Waste and Abuse Discovered in 2012 Medicare Ophthalmology Claims
In 2012, approximately 49 million Medicare claims were related to screening, diagnosis or treatment of cataracts, wet acute macular degeneration and/or glaucoma. Medicare paid approximately $3.5 billion for these particular…
CMS Just Announced New Provider Enrollment Provisions
As of December 3, 2014, new safeguards have been added to the CMS provider enrollment policies. CMS continues to focus on prevention of Medicare fraud, waste and abuse as part…
Are You Billing for Home Care Visits?
Physician home visits are under scrutiny by CMS for any possible fraud. In 2012, Medicare paid home care service providers about $236 million. As the population of Medicare age recipients…
What Should You Do After Discovering a Billing Error?
Just correct the problem and you will be compliant? No, but this is the first step in the right direction. According to the HHS in “A Roadmap for New Physicians…
Are You Aware of the Updated CMS Timeline for Meaningful Use?
Recent CMS modification allows more flexibility in certified EHR technology for 2014. Participation by providers will likely increase as will the ability to meet objectives such as e-prescribing, reporting quality…
OIG Special Fraud Alert Regarding Laboratories Payments to Referring Physicians
The OIG scrutinizes referring physician and laboratory arrangements. Two scenarios that involve transfer of value from laboratories to physicians are highlighted. These scenarios could represent possible fraud and abuse under…
Improper Payments for Evaluation & Management Services Cost Medicare Billions in 2010
According to the Office of the Inspector General’s report for 2010, Evaluation and Management services accounted for 30% of Medicare Part B payments, a total cost of $32.3 billion. However,…