Improper Medicare payments have fallen to their lowest level since 2010 due to “aggressive program integrity measures,” according to CMS.
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News
CMS announces Medicare FFS improper payment rate lowest since FY 2010
Source: ACDIS
Improper Medicare payments have fallen to their lowest level since 2010 due to “aggressive program integrity measures,” according to CMS. The Medicare FFS estimated improper payment rate dropped from 8.12% in FY 2018 to 7.25% in FY 2019.
MAOs may have used chart reviews to increase risk-adjusted payments, OIG says
Source: Revenue Cycle Advisor
Findings from a December Office of Inspector General (OIG) report show that CMS based an estimated $2.7 billion in risk-adjusted payments on chart review diagnoses that Medicare Advantage organizations (MAO) didn’t link to specific services. Their findings highlight concerns about the validity of payment data submitted to CMS.
 

Revenue Cycle Advisor Subscriber Content

Create systemwide compliance with the HIPAA Privacy Rule
Source: Revenue Cycle Advisor
With 2020 underway, it’s a good time for facilities to review the standards set forth by the rules that define HIPAA regulations. Without a thorough understanding throughout an organization, it can be easy for violations to occur.
 

Daily Q&A
Q&A: Submitting a Part A noncovered claim
Source: Revenue Cycle Advisor
Q: What is the process for submitting a claim for an inpatient hospitalization when our utilization review committee determined after discharge that the inpatient admission was not medically necessary?

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Upcoming CMS Events
Tuesday, 1/14 - ESRD Quality Incentive Program: CY 2020 ESRD PPS Final Rule Call
Wednesday, 1/15 - Listening Session on MAC Opportunities to Enhance Provider Experience
Thursday, 1/16 - MedicarePromoting Interoperability Program 2020 Webinar
Wednesday, 1/22 - Listening Session on MAC Opportunities to Enhance Provider Experience
 

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Seeing Through Pricing Transparency

With increased public and regulatory scrutiny and challenging new Medicare requirements set to go into effect in 2021, price transparency is one of the most complex challenges facing healthcare organizations. In this 90-minute webinar with live Q&A, Caroline Rader Znaniec, MBA, MS-HCA, will explain price methodologies and models, how they’re affected by price transparency, and how organizations can adapt.
 

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