Three university hospitals saw a doubling of Recovery Auditor audit activity from 2010–2011 to 2012–2013, and a nearly three-fold increase in overpayment determinations, according to a new study in the Journal of Hospital Medicine.
CMS is adequately preparing to implement ICD-10 October 1, according to a new Government Accountability Office (GAO) report detailing CMS’ transition efforts.
Physician documentation for the use of osteogenic stimulators for nonunion of fractures is often insufficient for Medicare coverage, according to Comprehensive Error Rate Testing (CERT) results .
The District of Columbia federal district court dismissed a lawsuit December 18, 2014, filed by the American Hospital Association (AHA) against HHS for excessive and inappropriate Recovery Auditor denials, according to AHA News. The AHA announced that it may appeal the court’s decision.
CMS Transmittal 547 changes the audit timeframe for complex reviews from 60 to 30 days for some MAC and Recovery Auditor reviews. The change could significantly affect the volume and timeliness of complex reviews for providers. The transmittal becomes effective February 24, 2015.
Beginning January 1, 2015, physicians will no longer need to provide certification for an inpatient admission unless the admission is expected to last for 20 days or longer or the case is an outlier.