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.

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.

1. Mylan Agrees to Pay $465 Million to Resolve False Claims Act Liability for Underpaying EpiPen Rebates - “Pharmaceutical companies Mylan Inc. and Mylan Specialty L.P. have agreed to pay $465 million to resolve claims

The OIG has frequently reviewed chiropractic services over the last several years. Their most recent report was posted on their website on Aug. 18, 2017 and concluded that a Brooklyn chiropractor had a 100% error rate for claims over a two-year period worth about $672,000.

340B Drug Pricing Program

The 340B drug pricing program was authorized by Congress in 1992 to generate savings for certain safety-net healthcare providers by allowing them to purchase outpatient drugs at discounted prices. It is estimated that the savings to 340B providers attributable to the...

The Centers for Medicare and Medicaid Services (CMS) issued the Reform of Requirements or Long-Term Care Facilities in 2016 with a three-part phased implementation.

Everyone is talking (and panicking) about Hierarchical Condition Categories (HCCs) lately and for good reason: HCCs are progressively being applied to numerous healthcare reform initiatives and it’s pretty confusing.