Articles
La. DHH Proposes New Rules to Limit Freestanding Emergency Departments
The Louisiana Department of Health (LDH) published two notices of intent in the July 2016 edition of the Louisiana Register related to free-standing emergency departments (EDs). One proposed rules would prohibit free-standing EDs from operating …..
Final 60-Day Rule for Reporting and Returning Overpayments
Quantification Required as Part of “Identifying” and Overpayment Six years after issuing its Proposed Rule, CMS released its final 60-Day Rule for reporting and returning overpayments. The Final 60-Day Rule is more industry-friendly, but still …..
CMS to Enforce 20 Hours per Week Therapeutic Services
Patients admitted to a partial hospitalization program (PHP) must be under the care of a physician who certifies the need for partial hospitalization and that the patient requires a minimum of 20 hours per week …..
Business Associates the Target of HIPAA Audits
For the first time since HIPAA was enacted in 1996, vendors and other business partners such as law firms and billing companies who handle health information on behalf of healthcare providers can be held directly …..
Medicare Appeals – Limiting the Scope of Review on Redeterminations and Reconsiderations of Certain Claims
CMS recently provided direction to A/B MACs and QICs regarding the scope of appellate review for redetermination (1st Level) and reconsideration (2nd Level) appeals of certain claims. Historically, MACs and QICs had discretion while conducting …..
OIG Issues Additional Compliance Guidance Emphasizing Responsibility of Governing Boards
A Hospital’s commitment to effective statutory and regulatory compliance starts at the top with the Hospital’s Governing Board. On April 20, 2015, the Office of Inspector General, U.S. Department of Health and Human Services (“OIG”) …..