Corporate Compliance

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• Note from the instructor: Manual medical review by Recovery Auditors of outpatient therapy claims begins April 1

  During the last quarter of 2012, hospital outpatient departments temporarily fell under the therapy caps and manual medical review provisions as required under the Middle Class Tax Relief and Job Creation Act. On January 2, 2013, the American Taxpayer Relief Act revised those provisions that impacted outpatient therapy services, including those provided in hospital outpatient departments for services furnished between January 1 and December 31, 2013. Click on the link above to learn about the details.

• Note from the instructor: Details released on Part A to B rebilling ruling

  Most of you reading this likely already know that CMS released a ruling on March 13 that revises Part B inpatient billing in hospitals, but how exactly are providers supposed to go about doing it? This article takes a look at the rebilling format, as well as denials that are subject to the ruling, timeframes for rebilling, and special considerations for pending appeals. Click on the link above to learn about the Part A to Part B rebilling details.

• HIPAA Q&A

  Chris Apgar, CISSP, CEO and president of Apgar & Associates, LLC answers your HIPAA questions on patient preference, incidental disclosures, and email blasts in this HIPAA Q&A. Click the link above to read more.

• CMS issues proposed changes to Part B inpatient billing in hospitals

  Effective Wednesday March 13, hospitals denied payment because a Part A inpatient stay was deemed not reasonable and necessary may rebill the claim under Part B. Click the link above to read the CMS notice of ruling, the proposed rule, and an HCPro analysis.

• CMS releases fiscal year-end improper payment figures for Recovery Auditors

  Recovery Auditors released their fiscal year 2012 improper payment figures on November 30. The numbers continue to grow, as CMS more than doubled its total correction amount from the previous year.

• Focus on CAHs: 2013 OIG Work Plan

  The Office of Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS) released on October 2 its annual Work Plan, which highlights 25 projects that examine CMS payments to hospitals under Part A and Part B.

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