Corporate Compliance

Other issuances: OIG issues a number of reviews and CMS issues fact sheet and press releases

Medicare Insider, November 27, 2012

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CMS issues notice on hospital outpatient payment panel

On November 27, CMS issued a notice in the Federal Register which announces meetings for the hospital outpatient payment panel this coming March, for which the panel will take comments for supervision levels.

View the notice.

OIG issues review of LifeCenter Northwest’s compliance with reporting organ statistics

On November 23, the OIG issued a review of LifeCenter Northwest, in which it found that it did not fully comply with Medicare requirements for reporting organ statistics in its fiscal year 2009 Medicare cost report. The review found that Medicare’s share of organ procurement costs was overstated by an estimated $88,000.
 
View the OIG report.
 
OIG issues review of advanced life support transports in Oklahoma
 
On November 23, the OIG issued a review which found that the Emergency Medical Services Authority of Oklahoma City inappropriately billed and Medicare paid for advanced life support (ALS) emergency transports in 2010. Of the 100 claims reviewed, 10 were not medically necessary, resulting in overpayments of at least $366,000.
 
View the OIG report.

CMS issues fact sheet on FY 2012 improper payment rates

On November 21, CMS issued a fact sheet that publishes the improper payment rates for CMS programs in fiscal year 2012.

View the fact sheet.

CMS issues press release on efforts to provide more information on healthcare quality

On November 21, CMS issued a press release which announces the first three participants in a program designed to help consumers get more information regarding their local doctors, hospitals, and other healthcare providers.

View the press release.

OIG issues Medicare compliance review of University of Iowa
 
On November 20, the OIG issued a Medicare compliance review of the University of Iowa Hospital in Iowa City, Iowa.. The review found that 274 of the 398 claims reviewed were billed incorrectly, resulting in $826,000 in overpayments for CYs 2008 through 2011.
 
View the OIG report.

OIG issues review of outpatient billing for a selected drug in California

On November 20, the OIG issued a review of Medicare outpatient billing for a selected drug at Community Hospital Long Beach Memorial in Long Beach, Calif. For the 19 line items reviewed, the hospital did not bill in accordance with Federal requirements, resulting in overpayments totaling $30,000.
 
View the OIG report.

OIG issues review of Noridian payments for Herceptin in Jurisdiction 2

On November 20, the OIG issued a review of Noridian payments in Jurisdiction 2 for full vials of Herceptin. The review found that 487 of 714 line items reviewed were incorrect, resulting in $567,000 in overpayments.

View the OIG report.

OIG issues review of outpatient billing for a selected drug in Arizona
 
On November 20, the OIG issued a review of Medicare outpatient billing for a selected drug at Banner Baywood Medical Center in Mesa, Ariz. For the three line items reviewed, the medical center did not bill in accordance with Federal requirements, resulting in overpayments totaling $54,000.
 
View the OIG report.

CMS issues press release on implementation of latest Affordable Care Act provisions

On November 20, CMS issued a press release which details the Obama administration’s action to implement provisions in the health care law that would make it illegal for insurance companies to discriminate against people with pre-existing conditions.

View the press release.



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