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The intersection of controversy and confusion is about to cause a pile up with providers, auditors and the ALJ as a result of a news article that's making the rounds entitled, "Two-Step Process for Clinical and Payment Decisions." The article, from the National Government Services (NGS), says it has a…
In less than 10 days after the OIG published its report critical of the Administrative Law Judges, comments and controversy continue to swirl around the OIGs recommendations. The report includes 10 recommendations intended to create an array of improvements and efficiencies in this critical level of appeals – though whom…
If you listen closely on this long Thanksgiving weekend, you just might be able to hear a collective sigh of relief coming from providers across the country. The OIG has released a report on challenges providers are encountering at the ALJ level. What is your reaction?
Dennis Jones reported on Monitor Monday today that some hospitals affected by Hurricane Sandy will experience some storm relief: Counties in affected FEMA-designated disaster areas will have no ADRs or denied claims for a lack of documentation for 60 days beginning Nov. 2, this according to the Greater New York…
Larry Goldberg, the principal deputy inspector general for HHS-OIG, will appear on a special edition of Monitor Monday, next Monday, Nov. 19th. Sources at the OIG tell Monitor Monday that he will be making two announcements — one dealing with personal care services through a new product called, "Portfolio;" he…
Comments continue to arrive regarding last week's RACmonitor article about the Medicare Audit Improvement Act, introduced last Wednesday.I am not surprised to see is that this was initiated in New York. Irrespective of your political affiliation, you have to admit that the state of New York is a consumer-oriented state,…
Hi Chuck. It is great to see that some people in Congress are aware of the problems with RAC audits. Some parts of this bill are certainly exciting. For example, it would be wonderful if RACs were required to compensate health care organizations when the health care organization prevails in…
Following up on the RAC Act, Mark Thomas, Esq., general counsel for HANYS, plus Lance Keilers from Ballinger Memorial in Ballinger, TX, will be on Monitor Monday, Oct. 22, 10 AM ET. Register Here!