The recent re-launch of Healthcare.gov aims to be a one-stop shop for information on the Health Insurance Marketplace. Although, the Marketplace itself won’t be up and running until October 1st when open enrollment begins, the site does contains up to date information on what to expect for individuals or families, as well as small businesses. Individuals and […]
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The OIG looking for improper payments made on Evaluation and Management (E&M) services is nothing new. This year’s Work Plan includes several items on E&M services, including services made during the global surgical period. New to this year they will also be looking at the modifiers used on E&M services performed during the global period. […]
In late March CMS announced that it was postponing the effective date for it’s new national policy regarding POS coding assignments. Transmittal 2435 delays the effective date from April 2nd 2012 to October 1st 2012. The Transmittal revises and clarifies how POS codes are assigned. In the past the policy was to report the POS code […]
State and federal governments are using advanced technology to find suspicious billing patterns that would indicate upcoding or unbundling, and when they find suspicious patterns, they aren’t just looking at the documentation. MedStar Health System’s Good Samaritan Hospital agreed to pay $793,548 to settle allegations that it submitted false claims to the to federal benefit programs from […]