OIG Criticizes CMS’s 16-Year Delay in Issuing Regulations; CMS Yawns

Turns out it’s not just health care providers that notice CMS’s foot-dragging. Last Thursday the Office of Inspector General (OIG) of Health & Human Services (HHS) published its report on what CMS has done—or rather, has not done—in response to a Congressional mandate issued in 1997. The mandate …

[Read more...]

Dark Clouds Over Sunshine Act

Once again the Obama administration has been tripped up in launching a healthcare-related online system.  This time the problem concerns the Physician Payments Sunshine Act—the act that is supposed to enable the public to see whether a physician has a financial relationship with a drug or device manufacturer.  …

[Read more...]

Bundling Gains Momentum, Even as New Study Raises Questions

Health care cost bundling—the aggregating of all the costs of an episode of medical care into a single bill—seems to be here to stay. After all, it’s the way most all other billing is done. When your car is serviced, you don’t get a separate bill from each mechanic and vendor of parts and fluids. And …

[Read more...]

Brace Yourself: The RACs Are Back

Yesterday the Centers for Medicare & Medicaid Services announced that it will restart the Recovery Audit Contractor (RAC) program this month, on a limited basis.  It’s been on hold since June. Under the controversial program private contractors audit hospitals and other Medicare providers for fraudulent …

[Read more...]

Most Recent Final Deadline for ICD-10 Implementation is October 1

It’s been a while since CMS set a new “final” deadline for implementation of ICD-10—the greatly expanded medical coding system. So last Thursday CMS issued a new final rule setting October 1, 2015, as the final date for implementation. This new final rule shouldn’t be confused with the April 30 …

[Read more...]

D.C. CIRCUIT SAYS CMS DOESN’T KNOW WHAT’S NEW

On Tuesday of last week the D.C. Circuit Court ruled that the Provider Review Reimbursement Board doesn’t know what’s new.  It reversed the PRRB’s decision, along with the District Court’s decision that upheld it.  In doing so, it threw up its hands (figuratively speaking), repeatedly complaining that it …

[Read more...]