The Latest News
Medical Coding Billing & Compliance News
compiled by Team eduTrax
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Written by Team eduTrax
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Friday, 03 September 2010 00:00 |
First Requests for Maximum Records Seen
Connolly Healthcare requested the maximum allowable number of records from many facilties in their region over the past few days, sending out Additional Documentation Request (ADR) letters immediately after posting approval for medical necessity review of 29 MSDRGs on August 30. The targeted facilities have never before seen requests for this number of records, since the permanent RAC project began.
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Written by Team eduTrax
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Wednesday, 01 September 2010 00:00 |
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Largest Ever Jury-granted Award for Damages in America
A jury returned a $677 million judgment against Skilled Healthcare Group, Inc. in a more than four-year-old class action lawsuit alleging that the company violated state mandated nursing coverage requirements in 22 of its nursing facilities over a six-year period, on Tuesday, July 6, 2010. At issue was a California statute that mandates 3.2 nursing hours per patient per day.
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Last Updated on Wednesday, 01 September 2010 18:27 |
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Written by Team eduTrax
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Monday, 30 August 2010 00:00 |
Same 29 MSDRGs Approved for CGI, HDI
Connolly Healthcare posted approvals today for the review of medical necessity for the same 29 MSDRGs already posted earlier this month by two other Recovery Audit Contractors (RACs), as reported here previously, on August 13. Unlike the other two RACs, however, Connolly has chosen to post these approvals as “new” issues, separate and apart from previous postings of some of the same MSDRGs already approved for DRG Validation, with medical necessity excluded.
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Written by AIS Health.com
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Thursday, 26 August 2010 00:00 |
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Report encourages CMS to Pursue Widespread Recovery
Medicare contractors overpaid physicians an estimated $13.8 million for claims with the incorrect place-of-service code during calendar year 2007, the HHS Office of Inspector General (OIG) says in an audit report (A-01-09-00503) posted Aug. 13, 2010.
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Written by Team eduTrax
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Monday, 23 August 2010 00:00 |
HDI Posts No New Issues, 29 DRGs Now Approved Medical Necessity Reviews
Health Data Insights (HDI), the CMS Recovery Audit Contractor (RAC) contracted for reviews of Medicare claims in 17 western states, posted approvals for the review of both medical necessity and DRG Validation for previously approved and listed issues including 29 DRGs, effective August 16, 2010. HDI is now approved to review medical necessity for the same DRGs recently approved by CMS for CGI, the RAC for Region B. No new issues were posted by HDI, since all the DRGs involved were already approved for DRG Validation previously.
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