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...
Senators demand more data on Medicare fraud prevention efforts
By
McKnight's Staff
Aug 01, 2012
A multimillion dollar Medicare fraud-fighting command center unveiled by the federal government a week ago is already drawing fire from two Republican lawmakers.
CMS to begin audits for schizophrenia coding, says citations will affect quality ratings
By
Alicia Lasek
Jan 19, 2023
The agency will start auditing nursing homes this month to determine whether residents’ schizophrenia diagnoses are accurate and appropriately coded. A pattern of inaccurate coding may result in a quality...
House committee puts Medicare audit contractors on the hotseat
By
McKnight's Staff
Jul 10, 2012
Lawmakers are asking Medicare contractors for more information about how they go about identifying and reporting potentially fraudulent payments to the Centers for Medicare & Medicaid Services.
The government often hires “overzealous” investigators to detect fraudulent Medicare and Medicaid billing practices, a new report alleges. These examiners often target technical errors instead...
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.
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...
Flurry of Medicare Advantage regulation likely to hit nursing home coffers
By
Kimberly Marselas
Feb 03, 2023
Federal efforts to rein in Medicare Advantage spending and recoup payments awarded for improper diagnoses will likely lead to even more financial pressure on nursing homes that serve plan beneficiaries,...
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...
Medicare audits ‘ramping up’ with isolation coding in the crosshairs
By
Josh Henreckson
Apr 22, 2024
Auditors are paying special attention to isolation and quarantine coding amid already heightened Medicare nursing home audits that are expected to increase in coming months, experts warn.