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Medicare Insider

Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and transmittals. Readers also find OIG audit reports, advisory opinions, and more.

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Medicare Insider

Issue 2, January 14, 2014

• Upcoming events

  CMS is hosting National Provider calls and Open Door Forums this week. Click the link above for...

Issue 9, March 4, 2014

• Note from the instructor: Billing Outpatient Laboratory Services - TOB 131 vs. TOB 141

    Click the link above for more information and an in-depth analysis.    

• The week in Medicare updates

  This week’s updates include a change request to implement compliance with NACHA operating...

• Recent Recovery Auditor activity

  Performant posted one new issue. Click the link above to read about the issues and see which states...

• Upcoming events

  CMS is hosting two Open Door Forums and two National Provider Calls in March. Click the link above...

Issue 8, February 25, 2014

• The week in Medicare updates

  This week’s updates include an MLN Matters Special Edition article to convey CMS&rsquo...

• Recent Recovery Auditor activity

  Connolly posted three new issues in three categories and CGI posted two new issues. Click the link...

• Upcoming events

  CMS is hosting two National Provider calls in February. Click the link above for registration...

Issue 7, February 18, 2014

• The week in Medicare updates

   This week’s updates include updates to the Medicare Claims Processing Manual, Reporting...

• Recent Recovery Auditor activity

  Performant Recovery posted new issues to its CMS approved list for providers. Click the link above...

• Upcoming events

  CMS is hosting two Open Door Forums and two National Provider calls in February. Click the link...

• Medicare Boot Camp® - Utilization Review Version

  Don’t leave money on the table! Medicare Boot Camp® - Utilization Review Version is an...

Issue 6, February 11, 2014

• Note from the instructor: OIG releases FY 2014 Work Plan

  We are four months into the new fiscal year and the Office of Inspector General (OIG) has finally...

• The week in Medicare updates

  This week’s updates include the updated OIG Work Plan, changes to the laboratory NCD software...

• Recent Recovery Auditor activity

  Performant Recovery posted new issues to its CMS approved list for providers. Click the link above...

• Upcoming events

  CMS is hosting two National Provider calls in February. Click the link above for registration...

• Medicare Boot Camp® - Utilization Review Version

  Don’t leave money on the table! Medicare Boot Camp® - Utilization Review Version is an...

• Hospital inpatient admission order and certification

  CMS has released additional clarification on the provisions of the 2014 IPPS Final Rule regarding...

Issue 5, February 4, 2014

• Note from the instructor: Extension of probe and educate audits; new guidance on inpatient orders by residents and ED docs

  On January 31, CMS announced on its Inpatient Hospital Reviews website that it extended the probe...

• The week in Medicare updates

  This week’s updates include probe reviews of inpatient hospital claims and corresponding...

• Recent Recovery Auditor activity

  Performant Recovery and Connolly posted new issues to its CMS approved list for providers. Click...

• Upcoming events

  CMS is hosting an Open Door Forum and a National Provider call in February. Click the link above...

• Medicare Boot Camp® - Utilization Review Version

  Don’t leave money on the table! Medicare Boot Camp® - Utilization Review Version is an...

Issue 3, January 21, 2014

• Note from the instructor: Lab billing details in the January 2014 OPPS update

  Last week, CMS released MLN Matters article MM8572 with billing instructions for laboratory...

• Note from the instructor: CMS issues guidance to implement calendar year 2014 outpatient changes

  In this week’s note, we will take a closer look at RUN transmittal R2845CP and related MLN...

• The week in Medicare updates

  This week’s updates include the January 2014 update of the Hospital Outpatient Prospective...

• The week in Medicare updates

  This week’s updates include registration of entities using the Indirect Payment Procedure...

• Recent Recovery Auditor activity

  No new items this week.

• Recent Recovery Auditor activity

  Performant Recovery posted one new issue to its CMS approved list for providers. Click the link...

• Upcoming events

  CMS is hosting a National Provider call in February. Click the link above for registration...

• Upcoming events

  CMS is hosting a National Provider call and an Open Door Forum in February. Click the link above...

• Medicare Boot Camp® - Utilization Review Version

  This Medicare primer goes beyond the 2-midnight rule by showing you the big picture on how the new...

• Medicare Boot Camp® - Utilization Review Version

  Don’t leave money on the table! Medicare Boot Camp® - Utilization Review Version is an...

Issue 2, January 14, 2014

• The week in Medicare updates

  This week’s updates include corrections to the hospital IPPS for acute care hospitals, the...

• Note from the instructor: 2-Midnight Rule clarifications continue

  As we await more instructions from CMS on implementation of the OPPS and MPFS final rule, I thought...

• Recent Recovery Auditor activity

  CGI posted new item to its CMS approved list for providers. Click the link above to read about the...

• CAH Method II overpayments related to the Annual Wellness Visit

  In July 2013, Medicare Administrative Contractors (MACs) began to recover overpayments on Annual...

Issue 1, January 8, 2014

• Note from the instructor: Confusion about device and procedure edits

  In the OPPS proposed rule, CMS had proposed to do away with the device to procedure and procedure...

• The week in Medicare updates

  This week’s updates include a final rule revising the exception on the physician...

• Recent Recovery Auditor activity

  Performant Recovery and HealthDataInsights posted new items to their CMS approved lists for...

• Join us on the podium at the 2014 Medicare Compliance Forum

  We are currently seeking speakers to present at the 2014 Medicare Compliance Forum to be held...

• Upcoming events

  CMS is hosting National Provider calls in January and February. Click the link above for...

Issue 51, January 2, 2014

• Note from the instructor: CMS updates Integrated Outpatient Code Editor (IOCE) to incorporate calendar year 2014 outpatient changes

  CMS issues certain quarterly updates relating to hospital outpatient services.These updates are...

• The week in Medicare updates

  This week’s updates include a final rule revising the exception on the physician...

• Recent Recovery Auditor activity

  No new items this week.

• Upcoming events

  CMS is hosting National Provider calls in January and February. Click the link above for...