Under the Affordable Care Act (ACA) physical therapists in private practice were elevated from a “low” risk in the enrollment category to a “moderate” risk. Physical Therapist in private practice were enrolled prior to 3/25/2011 are now required to revalidate their information. As part of the revalidation process a site visit will be performed to . . . → Read More: PT Private Practice Site Visits Required by Medicare
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CMS announced today that effective January 1, 2012 they will conduct demonstration projects designed to strengthen Medicare by aiming at eliminating fraud, waste, and abuse. Three programs were announced: Recovery Audit Prepayment Review: The Recovery Audit Prepayment Review demonstration will allow Medicare Recovery Auditors (RACs) to review claims before they are paid to ensure that the . . . → Read More: CMS Announces New Program Integrity Initiatives: More Recoupment Efforts Will be Forthcoming CMS has posted a listing of providers and suppliers who have received enrollment revalidation requests under the Affordable Care Act initiative requiring all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. Under Section 6401 (a) of the ACA those providers who enrolled prior to March 25, 2011 are required . . . → Read More: CMS Posts Listing of Providers Receiving Revalidation Notices The Office of the Inspector General (OIG) of the Department of Health and Humans Services has released is 2012 Work Plan. In a continued effort to stem abuses in comprehensive outpatient rehabilitation facilities (CORFs), the OIG will continue its work in this area. According to the Work Plan: We will review national Medicare utilization patterns . . . → Read More: OIG 2012 Work Plan and CORFs are Under Review The Senate Committe on Finance release a report today showing that home health companies intentionally increased frequency of home health therapy visits to manipulate Medicare reimbursement rates. Senate Finance Committee Chairman Max Baucus (D-Mont.) and senior Finance Committee Member Chuck Grassley (R-Iowa) released this report showing tactics used by major for-profit home health companies to game . . . → Read More: Senate Finance Report: Gaming of Medicare by For-Profit Home Health Companies On a recent MonitorMonday podcast sponsored by RACMonitor.com, Melanie Combs-Dyer, Deputy Director of the Compliance Group, CMS Office of Financial Management provided listeners with how the roll out of esMD will take place. Providers will now be able to submit medical records that have been requested by various contractor electonically, rather than via fax, mail . . . → Read More: CMS New Electronic Submission of Medical Records: esMD |
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