Medicare’s new method of calculating payment rates for laboratory tests could cost the agency billions in overpayments, according to a recent report from the U.S. Government Accountability Office.
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News
Rule proposes to give auditors more leeway
Source: ACDIS
Auditors could be able to extrapolate findings to larger pools of claims, according to a CMS proposed rule. An auditor could pull 30 claims, find a total overpayment of $1,000, which would mean an average of $33.33 per claim, and then extrapolate those findings to a larger group of 10,000 claims to say that the overpayment was nearly $350,000.
GAO: New payment rates for Part B lab tests may lead to billions in overpayments
Source: Revenue Cycle Advisor
Medicare’s new method of calculating payment rates for laboratory tests, intended to reduce Medicare spending by $360 million in the first year, could cost the agency billions in overpayments, according to a recent report from the U.S. Government Accountability Office (GAO). 
 

Revenue Cycle Advisor Subscriber Content

HIPAA, 42 CFR Part 2, and addressing the opioid crisis
Source: Revenue Cycle Advisor
The opioid crisis in the U.S. continues to touch on issues of patient rights and privacy. In October, the Office for Civil Rights launched an education campaign about civil rights protections that include specific guidelines for covered entities under HIPAA
 

Daily Q&A
Q&A: Reporting charges for substituted clinical trial drugs
Source: Revenue Cycle Advisor
Q: If a patient participating in a clinical trial is allergic to one of the drugs used in the trial, how do we report the drug that is used as a substitute?

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