Healthicity Blog

1. Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 - “Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 Parkridge Medical Center, Inc. (the Hospital), located in Chattanooga, Tennessee, complied with Medicare billing requirements for 88...

The Medicare Access and CHIP Reauthorization Act (MACRA)

The Medicare Access and CHIP Reauthorization Act (MACRA) of April 2015 will not only significantly change physician reimbursement, it will also change how we audit for correct coding and documentation.

Most of us have seen the emotionally charged video of University of Utah nurse, Alex Wubbels, being arrested by Salt Lake City Police after refusing to allow the police to draw blood from an unconscious patient.

1. Owner of Two New York Medical Clinics Sentenced to 84 Months for Her Role in $55 Million Health Care Fraud Scheme - “The owner of two Brooklyn, New York, medical clinics was sentenced today to 84 months in prison for her role in a $55 million healthcare fraud scheme.

The OIG has updated their work plan in the last year more frequently than in the past and recently added nine more items in September of 2017. Anytime the OIG updates their work plan, I think it’s important to take a deep dive into the new content.

There are a lot of Copy and Paste horror stories. Physicians who accidentally copy and pasted information from one patient’s record to a different patient. Or Copy and Pasting that goes rogue and suddenly, a woman with a family history of breast cancer has a history of breast cancer herself.

1. CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims - “Medicare Part B paid for some immunosuppressive drugs billed with the KX modifier that were not eligible for Part B payment.

When a lot of healthcare organizations consider their risk under the False Claims Act, they often think of coding and billing errors submitted on 1500s or UBs. It’s probably the first place I’d consider looking as well for the greatest risk to a Medicare or Medicaid healthcare provider.