On January 1, 2012, the Centers for Medicare & Medicaid Services (CMS) will officially implement the Medicaid recovery audit contractor (RAC) program—a very close cousin to the Medicare RAC program. Those states that haven’t already done so, and there are several that have, must hire Medicaid RACs to perform post-payment claim reviews and then identify and recover improper payments.
Click Here to view a replay of the How to Avoid Penalties by Understanding and Reducing Your Hospital Readmission Rates webinar. The CMS readmission penalty is up to 1% of all Medicare IPPS payments in FFY 2013 climbing to 3% in 2015. Hospitals with higher readmission performance as compared to expected readmissions will face millions in lost payments.
Providers may choose to not enter into corporate integrity agreements (CIAs) after they have settled fraud cases. The OIG has decided to target these entities according to the OIG Work Plan for 2012.
Click Here to view a replay of the Easing the Information Security Compliance Burden for Health Care webinar. This webinar will cover the massive Health Care IT transformation currently underway and how this impacts health care information security compliance. Feisal will cover Health Care IT Audit / Compliance requirements, security and mapping security to various compliance requirements. Review the compelling needs for using a framework to manage the process and a strategy for executing within the framework.
With ICD-10 just around the corner, many facilities are in the process of reviewing their physician documentation and their coding and querying processes in the Health Information Management (HIM) department and Clinical Documentation Improvement Programs (CDIP). These reviews are being performed to determine – will my documentation be sufficient for ICD-10 coding requirements. Do my coding processes result in compliant and optimal claims?
The 2012 ICD-10-PCS Update is available for download on the CMS website at:http://www.cms.gov/ICD10/11b15_2012_ICD10PCS.asp#TopOfPage.In addition to the Index and Table file, the 2012 Guidelines are also posted.This is the last full update that will be published prior to the implementation date of October 1, 2013.
You would almost think that after all these years there really couldn’t be many additional CPT procedure code set updates. The 2012 codes, however, have been released and we do find another year with new codes, definition changes and deleted codes. Some changes are of course more dramatic than others. For example, there are a lot of new laboratory codes for genetic testing, which is not surprising given that this an emerging area in medicine. Next to lab I think the areas with the greatest number of changes for 2012 are cardiology and pain management.
