OIG: Regulators need to sharpen retrieval of Medicare overpayments made to providers
By
McKnight's Staff
May 25, 2012
Medicare recovery audit contractors have not been diligent enough in collecting previously identified overpayments, a government investigation finds.
Claims audit will affect every nursing home starting June 5
By
Kimberly Marselas
May 30, 2023
Every skilled nursing facility in the US will be subject to a five-claim audit starting the week of June 5 as regulators try to better assess and root out improper payments.
‘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.
After record penalties, providers can protect themselves from the DOJ with 3 priorities, experts say
By
Joe Bush
Nov 28, 2022
The Department of Justice is on pace to hand out a record $5.6 billion-plus in total fines and penalties under the False Claims Act this year, a clear indicator that the agency has removed the kid gloves...
SNF rehab claims scrutinized more than ever, expert says
Jul 11, 2012
Nursing home administrators who can’t substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert...
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.
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.
Headed for the Provider Relief Fund reporting portal? Consider these tips first.
By
Kimberly Marselas
Jul 20, 2021
Confusion and uncertainty are clouding the landscape as nursing homes across the country begin reporting lost revenues and COVID-19 related expenses that would allow them to keep their share of federal...
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....
Providers warned: Ongoing relief fund audits may bring unprecedented info demands
By
Joe Bush
Nov 21, 2022
Provider Relief Fund audits have started in earnest, with the threat of federal investigators demanding more and different data than most skilled nursing providers have ever been asked to account for.