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- Accepting applications for program coordinator award
Nominate a coordinator colleague or yourself for our new award celebrating the professionalism of residency and fellowship coordinators.
- Providers report first RAC denials in Florida, South Carolina
Healthcare providers in several states received their first RAC denials. Connolly Healthcare, the Region C RAC for Florida, South Carolina, and several other states, has been behind many of them.
- Note: More on deductibles and coinsurance
CMS recently published the Part A deductible and coinsurance and Part B deductible amounts for CY 2010. For most covered inpatient stays, as well as covered outpatient services, Medicare does not pay the entire Medicare allowable for those stays or outpatient services. Beneficiaries generally are responsible for a portion of the Medicare allowable in the form of deductibles and/or coinsurance.
- HealthDataInsights posts several new RAC DME claim issues
HealthDataInsights (HDI) has added multiple new RAC issues to their CMS-approved list in late October and early November. The new issues are approved for RAC audits in Region D for DME claims.
- Could RAC mass adjustment changes mean increase in automatic audits?
Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, but no such limits exist for the number of automatic reviews RACs can perform.
- Nation's largest nursing home pharmacy to pay $98 million for kickback schemes
The nation’s largest nursing home pharmacy, Omnicare Inc., will pay $98 million to resolve allegations that it violated the False Claims Act and participated in several kickback schemes, according to a Department of Justice (DOJ) press release. Drug manufacturer, IVAX Pharmaceuticals, will pay $14 million to resolve allegations that it engaged in kickback schemes with Omnicare.