Government Audit Insider: Health plan administrator makes positive changes
Healthcare Auditing Weekly, March 13, 2007
Peoples Health Network, the administrator of Tenet Choices, Inc.'s Tenet Choices 65 health plan, was found to have appropriately used its payment increase during 2004, according to an OIG audit.
Peoples Health used the increased Medicare capitation payments to reduce beneficiary cost sharing, enhance benefits, and stabilize beneficiary access to providers.
Also, Peoples eliminated physical therapy and vision hardware copayments, reduced copayments on prescription drugs, waived member enrollment fees for the prescription drug discount cards, and increased the percentage of premiums passed through to providers.
Read the entire OIG report here.
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- HIPAA Q&A: Level of encryption needed for email
- Topic: CMS, OESS post new security compliance review information, checklist
- Capturing all necessary codes for IUD insertion and removal can be challenging
- What does case-mix index mean to you?
- OB services: Coding inside and outside of the package
- QA:Coding multiple initial infusions
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- HIPAA Q&A: Level of encryption needed for email
- Q&A: Follow CMS' coding guidelines when using modifier -25
- What does case-mix index mean to you?
- Catch up on what's new with injections and infusions
- New conflicts of interest create new challenges
- Q/A. One injection code or two?
- Do not code 57288 with 52000
- Searched