Roundup: Relevant Medicare updates
Recovery Auditor Report, November 29, 2012
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.
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.
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.
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.
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.
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.
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.
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.
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