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The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently conducted an audit of Mount Sinai Hospital in New York City. After looking at a sample, the OIG found fault with about $1.4 million in claims, and projected that to an overpayment of just under $42…
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In 2009, the headlines read that rural children’s mental health was being overlooked and disregarded.” Fast forward nearly 10 years, and the headlines still remain more or less the same, even in the days leading up to this week’s Children’s Mental Health Awareness Day. It is tragic that today more…
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There is no doubt that state Medicaid Fraud Control Units (MFCUs) have their hands full and are charged with a difficult task. They are responsible for investigating Medicaid fraud. This is part of the responsibility assigned to them by the Centers for Medicare & Medicaid Services (CMS) as a mandate for…
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The Centers for Medicare & Medicaid Services (CMS) will be changing the criteria for short-stay audits in April, according to KePRO, one of the Medicare Quality Improvement Organizations (QIOs), which posted the announcement on its home Web page.“CMS is changing the selection process for medical records for short-stay reviews,” the…
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With unusual bipartisan support, a new piece of legislation of about 1,000 pages was signed into law on Dec. 13, 2016 – the 21st Century Cures Act. The Act will allocate about $6 billion to a variety of medically related needs. While the bill has received both applause and criticism…