The OIG has issued their Semi Annual Report to Congress for the period, October 1, 2020 through March 31, 2021. The Spring 2021 Semi Annual ...
CMS Issues Price Transparency Warnings
CMS has sent its first wave of warning letters out to hospitals who have not complied with federal rules requiring them to disclose payer-negotiated p...
OIG Highlights Hospital Coding & Billing Risk Areas
With the slowing of COVID-19 cases in many parts of the country, CMS and the OIG are getting back to auditing high risk areas of regulatory compl...
2022 IPPS Proposed Rule
On April 27, 2021 CMS issued the proposed rule for FY 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The deadline for comment is ...
OIG Plans to Audit Dermatology E/M Claims
The April update to the OIG Work Plan has been released. The newest update includes dermatology claims for evaluation and management (E/M)...
AMA Plans Another E/M Overhaul in 2023
The AMA released their CPT Editorial Summary on March 5th. It contains a number of proposed E/M changes to several categories/service types that...
Significant Clarifications for Outpatient E/M
The AMA issued a recent CPT update which contained important guidance regarding what may and may not be considered in determining the level of medical...
AMA Releases Important Updates
The AMA released their CPT Errata and Technical Corrections document on March 9th . The document largely includes clarifications and updates to t...
OIG Recommends Targeted Audits of MS-DRGs
Last week, the OIG released a report on Part A claims for inpatient hospital stays from FY 2014 through FY 2019. The report indicates that approximate...
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