‘Audits are back,’ and COVID-19 care is in the hot seat
By
Kimberly Marselas
Apr 21, 2021
Flexibilities granted to providers during the ongoing public health emergency are likely to result in increased medical reviews and automated denials, a therapy billing specialist is warning.
AHRQ offers new nursing home audit resources aimed at COVID prevention
By
Alicia Lasek
Apr 05, 2021
The Agency for Healthcare Research and Quality has released a comparison tool for differentiating competency checks vs. observational audits, and a step-by-step guide to help establish an effective observational...
Federal judge blocks new RAC contracts
By
Tim Mullaney
Sep 04, 2014
Adding to the ongoing controversy around Medicare’s Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.
CMS to hold Medicare Advantage conference
Jun 12, 2014
The Centers for Medicare & Medicaid Services will hold its Medicare Advantage & Prescription Drug Oversight & Enforcement 2014 Program Audits conference on Tuesday, June 24 .It is designed to “provide...
OIG revenues off $1 billion as oversight relaxes
By
John Hall
May 28, 2014
Revenues from Department of Health and Human Services Office of Inspector General audits and investigations for the the first half of fiscal 2014 are expected to drop almost $1 billion from the same period...
Preparing charge nurses for success!
By
Susan LaGrange
Nov 15, 2013
Today more than ever, we hear about the importance of PROACTIVE approaches to prevent as many unfavorable events as possible. One of the key essential proactive approaches that we can implement is to PREPARE...
Make CMS audits less burdensome, providers urge lawmakers
By
McKnight's Staff
Apr 29, 2013
The Centers for Medicare & Medicaid Services could take a variety of steps to make audits less burdensome, healthcare providers stated in white papers submitted to members of the Senate Finance Committee....
Upon further review
By
Julie Williamson
Apr 01, 2013
Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.
OIG: Electronic health records vulnerable to mispayments
By
McKnight's Staff
Nov 30, 2012
EMRs are expected to become the norm for healthcare providers in the future. But in the infancy of their use, they lack oversight and safeguards, a new report says.
Why are more RAC audits happening? There are trillions of reasons
By
John O'Connor
Sep 10, 2012
Recovery audit contractors are stepping up their efforts to review Medicare billings. This appears to be a classic case of auditors gone wild.