YouCompli

MARCH 22, 2023

There has been significant enforcement over the last couple years relating to overpayments for UDT. The second type is typically called quantitative or definitive drug testing. According to the OIG, prior error rate testing has suggested an improper payment rate of almost 30% for Medicare. The answer is urine drug testing (UDT).

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Overpayments Overpayment Compliance Medicare 52

Healthcare Law Today

JANUARY 2, 2023

As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition. And, a provider is required to refund overpayments it is obliged to refund within 60 days of such identified overpayment.

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Overpayments Overpayment ACA Medicare 52

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.

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COVID-19 Telemedicine Compliance Informed Consent 59

YouCompli

OCTOBER 26, 2022

The net of it is this: Our Compliance Department performed a compliance audit related to sleep studies that resulted in a significant payback to the federal government that could have been avoided if monitoring was being performed by the Sleep Center Clinical leadership. That’s a 41% error rate with an extrapolated overpayment of?$269

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Compliance Compliance Officers Overpayments Overpayment 52

Hall Render

JANUARY 19, 2024

Bipartisan Ky. hospital company Kansas City Orthopaedic Institute appoints new CEO Kansas City University’s new research center aims to answer: ‘How do we keep people well?’

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Nursing Homes Nurses Hospitals COVID-19 40

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). Health Equity in Medicare Advantage. We’ve summarized some of the key changes in the Proposed Rule.

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