Medicare Compliance Rac Oig

Medicare contractors should more closely examine providers’ bad debt claims, HHS watchdog says

Medicare administrative contractors (MACs) soon could apply more scrutiny to providers’ reported bad debts if CMS implements recommendations from the HHS Office of Inspector General (OIG). OIG in December issued a report in which it examined bad-debt reimbursement claims on Medicare cost reports spanning 2016 through 2018 for 67 randomly selected providers (including 29 hospitals). In those…

Nick Hut January 3, 2023

Healthcare News of Note: Advocate Aurora Health and Atrium Health megamerger complete

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: Atrium and Advocate Health close merger deal, CMS details expectations of hospitals in memo addressing workplace violence, and CMS plans to recoup $650 million in overpayments to Medicare Advantage plans.

Deborah Filipek December 12, 2022

New rule sets forth proposed Medicare payment policies for rural emergency hospitals

For hospitals that choose to begin operating under the new rural emergency hospital designation in 2023, Medicare will pay for any service that would be covered as a hospital outpatient department service.

Nick Hut July 21, 2022

Medicare spells out proposed conditions of participation for rural emergency hospitals

Seeking to shore up operations for rural hospitals, CMS issued a proposed rule that establishes recommended regulations for the new rural emergency hospital category.

Nick Hut July 5, 2022

Some Medicare payments to hospitals for bariatric surgery may be inappropriate, OIG finds

Medicare could have saved nearly $48 million in bariatric surgery payments to hospitals during an 18-month period if coverage rules and guidance were better implemented at the contractor level, according to the HHS Office of Inspector General.

Nick Hut May 17, 2022

As COVID-19 vaccination deadlines arrive for healthcare providers, CMS offers explanatory resources

As the deadlines arrive for providers to comply with the COVID-19 vaccine mandate, CMS has made various resources available to help healthcare entities determine whether and when the regulations apply to them.

Nick Hut January 27, 2022

HHS’s Office of Inspector General announces audit of providers’ COVID-19 billing practices

OIG has announced an audit of Provider Relief Fund recipients to ensure they did not balance-bill presumptive or actual COVID-19 patients.

Nick Hut January 26, 2022

Supreme Court agrees to review the vaccine mandate for healthcare workers in upcoming weeks

The nation’s highest court is being asked to clarify whether implementation of CMS’s COVID-19 vaccine mandate can proceed.

Nick Hut December 27, 2021

The vaccine mandate for healthcare workers is back in place for half the country following an appeals court ruling

The question of whether healthcare employees can be covered by vaccine mandates likely will be decided by the Supreme Court.

Nick Hut December 16, 2021

10 states file lawsuit to halt CMS’s new rule requiring healthcare staff to be vaccinated

The suit says CMS didn’t have a good rationale for implementing the mandate and failed to follow required procedures for handing down such regulations.

Nick Hut December 1, 2021
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