The 2023 Medicare Fee-For-Service Improper Payments Report was just released. The report identified an estimated $31.23 billion in improper payments with a payment error rate of 7.38%. The report outlines findings related to services most frequently billed and paid in error and outlines the reasons for the errors such as
The OIG has issued their Semiannual Report to Congress for the period April 1, 2023 through September 30, 2023. The report highlights $3.44 billion in expected investigative and audit recoveries identified during the entirety of FY 2023. The report also details the OIG’s ongoing work through investigations and enforcement actions over the past
The 2024 OPPS Final Rule was published last week and contained significant updates and changes to the hospital price transparency rules, many of which are effective January 1, 2024. Although there is no grace period, some requirements will be phased in. The new requirements come on the heels of the
Office of Inspector General (OIG) released their new General Compliance Program Guidance (GCPG) today and it is a must-read for all healthcare compliance professionals. The document outlines new, extensive, expectations for corporate compliance programs. The 91 page document contains numerous “tips”, regulatory citations and links to additional resources. The OIG
CMS released both the 2024 MPFS and OPPS Final Rules on Thursday. Both Rules formally adopt many major changes for the upcoming year including: 2024 MPFS 3.4% decrease to the conversion factor (CF). The new CF is $32.74, a decrease of $1.15 form the current 2023 CF of $33.89 Implementation of
The 2024 Medicare Physician Fee Schedule Final Rule was released today. In a shocking turn of events, CMS announced in the Final Rule they will be adopting the 2024 AMA definition of substantive portion for split (or shared) visits. Specifically, CMS stated, “we are finalizing a policy that reflects a
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