Corporate Compliance

Other Issuances: CMS selects final MACs, OIG issues report on high-dollar claims, and more

Medicare Insider, January 13, 2009

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CMS announces results of hospital quality reporting for outpatient services

On January 8, CMS issued the first results of its Hospital Outpatient Quality Data Reporting Program. Of the hospitals participating in the program, 99.3% will receive the full payment update for calendar year 2009.

View the press release.

CMS selects final set of Medicare administrative contractors (MAC)

On January 7, CMS announced its selection of the last group of Part A/Part B MACs. CMS contracted with five MACs to process Part A/Part B claims across 14 states, in jurisdictions six, eight, 10, 11, and 15.

View the fact sheet.

View a related press release.

OIG issues report on high-dollar inpatient claims processed by Cahaba Government Benefit Administrators for the period January 1, 2004, through December 31, 2006

On January 7, the OIG issued a report on high-dollar inpatient claims processed by Cahaba Government Benefit Administrators, a Medicare fiscal intermediary, for the period January 1, 2004, through December 31, 2006. The OIG found that Cahaba overpaid Iowa hospitals by $17,000 during that time period.

View the OIG report.

CMS posts proposed decision memo for FDG positron emission tomography (PET) for solid tumors

On January 6, CMS posted a proposed decision memo for FDG PET in which it proposed a new coverage framework. CMS would replace the current four-part diagnosis, staging, restaging, and monitoring response to treatment categories with a two-part framework that differentiates FDG PET imaging used to inform the initial treatment strategy from other uses related to guiding subsequent treatment strategies after the completion of initial treatment.

View the proposed decision memo.

CMS issues national coverage determination (NCD) for thermal intradiscal procedures (TIP)

On January 6, CMS posted an NCD for TIPs in which it implements its non-coverage decision for these procedures.

View the NCD.



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