CMS Releases Updated Guidance for LTC Surveyors
December 17th, 2014
On November 26, 2014, CMS issued revisions to State Operations Manual (SOM) Appendix PP for health and safety in long-term care facilities. The majority of the revisions were explained in advance guidance through survey and certification letters (S&a…
Read More
Read More
Categories: Client Advisory
HHS Releases Guide to Medicare Enrollment and Claims Submission
November 25th, 2014
The Department of Health and Human Services recently released an informational booklet to help providers navigate the Medicare system. Specifically, the booklet contains helpful guidance on wide range of issues relevant to Medicare providers and supp…
Read More
Read More
Categories: Uncategorized
In 2015 Work Plan, OIG Targets HIPAA Compliance
November 7th, 2014
Each year, the U.S. Department of Health and Human Services Office of Inspector General (OIG) releases a Work Plan that informs the public of planned audits, evaluations, and other legal and investigative activities that the agency plans to pursue du…
Read More
Read More
Categories: Client Advisory
Submit Claims Without Getting the RUG Pulled Out from Under You: Using PEPPER to Season SNF Compliance Programs
August 4th, 2014
May 2014 marked the second annual release of the Program for Evaluating Payment Patterns Electronic Reports (PEPPER) for skilled nursing facilities. The PEPPER contains billing data for episodes of care in six “target areas” that CMS has identifi…
Read More
Read More
Categories: Client Advisory
The New Medicaid Reimbursement System Rolls Out Today: The Nursing Facility Price-Based Payment Methodology
July 1st, 2014
In a June 9, 2014 Medicaid Memo, the Department of Medical Assistance Services (DMAS) announced the upcoming implementation of the Nursing Facility Price-Based Payment Methodology. [i] This new payment system will be effective for all Medicaid claims…
Read More
Read More
Categories: Client Advisory
Payments for Evaluation and Management Services: Where OIG Sees Smoke, Physicians Come Under Fire
June 24th, 2014
On May 28, 2014, the Office of Inspector General (OIG) published its findings from a study aimed at determining the error rate in physician coding for Evaluation and Management (E/M) services. The study focused on E/M services billed in 2010, noting…
Read More
Read More
Categories: Client Advisory
Provider Pocketbook Penalties: Changes to CMP Regulations on the Horizon
May 23rd, 2014
In a notice published on May 12, 2014, the Office of Inspector General (OIG) proposed changes and clarifications to regulations governing health care fraud and abuse and Civil Monetary Penalties (CMPs). In addition to a general reorganization of the…
Read More
Read More
Categories: Client Advisory
Security Risk Assessment Tool Released to Aid in HIPAA Compliance
April 9th, 2014
The U.S. Department of Health and Human Services (HHS) has released a Security Risk Assessment (SRA) Tool to aid small and medium sized providers in their compliance with the HIPAA Security Rule. The Tool was developed in collaboration with the Natio…
Read More
Read More
Categories: Client Advisory
Fourth Circuit Sends Virginia COPN Challenge Back to District Court for Further Fact Finding
October 28th, 2013
In a decision released October 23, 2013, the United States Court of Appeals for the Fourth Circuit partially reversed a federal district court’s dismissal of a constitutional challenge to Virginia’s Certificate of Public Need (COPN) law. http://w…
Read More
Read More
Categories: Client Advisory
October 1, 2013 Deadline for Notices to Employees of Health Insurance Coverage Options
October 1st, 2013
October 1, 2013 is the official deadline for all employers subject to the Fair Labor Standards Act (“FLSA”) to provide notices to current and new employees of the health insurance coverage options available through the employer and the health ins…
Read More
Read More
Categories: Client Advisory
