Hospitals Medicaid Medicare Overpayment 
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.
Healthcare Compliance Blog
APRIL 14, 2022
The Office of Inspector General (OIG) released their findings of an audit they conducted to determine if hospital admissions of Indiana skilled nursing facility (SNF) residents who are enrolled in both Medicare and Medicaid (dually eligible beneficiaries) were potentially avoidable, and if level-of-care requirements for Medicare were met.
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Health Care Law Brief
APRIL 12, 2023
On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.
The Health Law Firm Blog
NOVEMBER 18, 2023
Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]
The Health Law Firm Blog
AUGUST 23, 2022
Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].
Compliancy Group
FEBRUARY 7, 2024
This is because the Centers for Medicare & Medicaid Services (CMS) have ramped up their efforts to identify organizations that have improperly billed for medical services. The Centers for Medicare and Medicaid Services (CMS) created UPIC audits to identify and stop fraud and abuse in Medicare and Medicaid.
McBrayer Law Blog
NOVEMBER 18, 2020
Posted In Code Enforcement , Hospitals It may seem like hair-splitting, but including the wrong diagnostic codes for malnutrition on hospital inpatient claims – using codes for severe malnutrition in place of other forms of malnutrition – is a costly mistake.
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