Billing, Medicare, Medicare Part B

Urinary Catheter Fraud Sparks Proposed Medicare Payment Changes for ACOs

K&L Gates LLP on 7/8/2024

Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program got good news from The Centers for Medicare and Medicaid Services (CMS) related to widespread fraud involving urinary catheters that...more

While Remote Supervision Remains Available for Direct Supervision, Be Mindful of the Other “Incident to” Requirements

Bass, Berry & Sims PLC on 5/12/2023

With the May 11, 2023 expiration of the federal public health emergency (PHE) for COVID-19, many operational flexibilities healthcare providers used during the PHE will now sunset. Some flexibilities end immediately while...more

Hospice Audit Series: Beyond Part D, OIG Scrutinizes the Hospice Industry to the Tune of $6.6 Billion

Husch Blackwell LLP on 3/16/2022

In a follow-up to its recent reports on billing outside the hospice benefit for drugs and durable medical equipment (DME), the Office of Inspector General’s (OIG) new data report identifies billions being billed to Medicare...more

OIG Reports That CMS Paid Practitioners For Telehealth Services That Failed To Meet Medicare Requirements

Robinson+Cole Health Law Diagnosis on 4/27/2018

On April 5, 2018, the Office of the Inspector General (OIG) announced its findings that the Centers for Medicare and Medicaid Services (CMS) paid practitioners for telehealth services that did not meet Medicare requirements....more

Budget Proposal Would Limit Provider-Based Status - New Off-Campus Departments Limited to Physician Fee Schedule or ASC Payment...

King & Spalding on 10/28/2015

On October 26, 2015, Congressional and White House budget negotiators released the legislative text of the Bipartisan Budget Act of 2015. The Act is aimed primarily at lifting the Federal debt limit and avoiding a looming...more

2014 OIG Work Plan: Questionable Billing Patterns for Part B Services During Nursing Home Stays

Tucker Arensberg, P.C. on 2/17/2014

The 2014 OIG Work Plan includes the following: Billing and Payments. We will identify questionable billing patterns associated with nursing homes and Medicare providers for Part B services provided to nursing home...more

Available Recording of Roundtable on CMS Ruling 1455-R and Proposed Rule on Part B Rebilling Issues

King & Spalding on 4/22/2013

King & Spalding recently hosted a Roundtable Webinar focused on CMS Ruling 1455-R and Proposed Rule 1455-P. Both of these developments are of great interest to the healthcare industry because they have a significant impact on...more

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