Lauren Ambler

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 …..

2024-07-09T17:18:34-05:00July 14th, 2016|Categories: Health Law, Medicare & Medicaid Payment Rules|Tags: , |

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”) …..

2024-07-10T17:10:17-05:00April 30th, 2015|Categories: Health Law|Tags: , |

Automatic Denial Authority for “Related claims” – REDUX

CMS Provides MACs, CERT, RACs, and ZPICs with Automatic Denial Authority for “Related claims” – REDUX You may recall earlier this year, CMS issued a Transmittal giving MACs, RACs, CERT contractors, and ZPICs discretion to automatically …..

2024-06-11T11:05:26-05:00August 8th, 2014|Categories: Health Law|Tags: , |

Automatic Denial Authority for “Related claims”

CMS Provides MACs, CERT, RACs, and ZPICs with Automatic Denial Authority for “Related claims” Effective March 6, 2014, CMS amended the Medicare Program Integrity Manual giving MACs, RACs, CERT contractors, and ZPICs discretion to automatically …..

2024-07-10T17:30:18-05:00March 6th, 2014|Categories: Health Law|Tags: , |
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