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Medical Coding Billing & Compliance News

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Connecticut Hospital Agrees to $191,193 Civil Settlement with Fed
Written by Team eduTrax   
Tuesday, 02 March 2010 21:24

eduTrax News Service -- Feb. 28, 2010.

JOHNSON MEMORIAL HOSPITAL ENTERS INTO $191,193 FEDERAL CIVIL SETTLEMENT AGREEMENT

The US Attorney's Office District of Connecticut published a Press Release on February 22, 2010, announcing that JOHNSON MEMORIAL HOSPITAL, Stafford Springs, Connecticut, entered into a civil settlement agreement with the Government. The hospital did not admit liability in the case, but agreed to pay $191,193 to resolve allegations that it violated the False Claims Act.

Last Updated on Tuesday, 02 March 2010 21:47
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Connolly Continues to Post High-Dollar Issues for Review
Written by Team eduTrax   
Wednesday, 10 February 2010 00:00

eduTrax News Service - February 10, 2010.

Region C RAC Adds 19 New Issues

Connolly Healthcare, the RAC for Region C (south & southeastern states), posted 19 new approved issues for review on their RAC Issues page, on Monday, February 8, 2010. Following the format they have been using to date, the listed issues include only single MS-DRGs, but are still not listed in any particular order. All of the new issues are approved for DRG Validation, affecting all thirteen of the Region C states (AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, SC, TN, TX).

Last Updated on Friday, 19 February 2010 18:37
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All RACs Approved for Complex Reviews
Written by Team eduTrax   
Thursday, 21 January 2010 00:00

eduTrax News Service - January 21, 2010.

DRG Coding and DRG Validations Approved for All Permanent RACs

The Centers for Medicare & Medicaid Services (CMS) approved all four of their Recovery Audit Contractors (RACs) to begin review of Medicare claims for Complex Review. The specific target areas for review, at this time, include DRG coding and DRG Validation. Medical Neccessity is not yet under review, despite the requirements stated by the Medicare Program Integrity Manual itself. ...

Last Updated on Thursday, 18 February 2010 00:12
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CMS RACs Approved for Over 500 DRG Validation Issues
Written by Team eduTrax   
Thursday, 07 January 2010 22:19

eduTrax News Service - January 7, 2010.

Region D RAC Posts 530 Issues for Complex Review

530 MS-DRGs Approved for DRG Validation and MS-DRG Coding Review

Health Data Insights (HDI) posted on their website 66 new approved issues for review, late yesterday, January 6. HDI is CMS's Recovery Audit Contractor (RAC) for several states in the western US. The issues posted by HDI are all for MS-DRG coding and DRG validation, but medical necessity is specifically excluded from review, at this time.  The list of MS-DRG’s included in the issues represent both medical and surgical cases, and totals 530 of the 747 existing MS-DRGs, or 70% of all DRGs. Taken together, the four RACs are approved for over 570 DRG Validation issues.  Click title to read more...

Last Updated on Sunday, 10 January 2010 21:36
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CMS Issues Two New Regs on 'Meaningful Use'
Written by Team eduTrax   
Thursday, 07 January 2010 22:19

eduTrax News Service - January 8, 2010.

New Proposed Rule Governs EHR Incentive Programs, Defines 'Meaningful Use'

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued two new regulations listing the "meaningful use" criteria healthcare providers must meet in order to quality for federal funding of their information technology (IT) projects under the American Recovery and Reinvestment Act of 2009 (ARRA), on December 30, 2009, just under the statute's deadline. ....

Last Updated on Sunday, 10 January 2010 21:38
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