Magnifying Glass

OIG Announces $3.44 Billion in Expected Recoveries from Audits, Investigations 
OIG Announces $3.44 Billion in Expected Recoveries from Audits, Investigations 

Sarasota, FL (WorkersCompensation.com) – Earlier this week, the OIG released their Semiannual Report to Congress detailing their audit findings for reporting period April 1 through September this year, which included activity from October 2022 through […]
CMS Announces $31.2 Billion in Improper 2023 Payments
CMS Announces $31.2 Billion in Improper 2023 Payments

Sarasota, FL (WorkersCompensation.com) – Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released their findings of Fee-for-Service claims audits conducted this year.  Last year, CMS estimated that the rate of improper payments […]
CMS Holds Webinar on Sec. 111 Reporting of Work Comp MSA Information  
CMS Holds Webinar on Sec. 111 Reporting of Work Comp MSA Information  

Shawn DeaneGeneral Counsel & Vice President of Claims Solutions | J29 Solutions  Shawn.Deane@j29inc.com   On November 13, 2023, the Centers for Medicare & Medicaid Services (CMS) held a webinar on anticipated changes with respect to the potential […]
CMS Final Rule Reduces Physician Reimbursement Again 
CMS Final Rule Reduces Physician Reimbursement Again 

Sarasota, FL (WorkersCompensation.com) – Despite strong complaints from the American Medical Association (AMA) about a 26 percent decrease in physician reimbursement from 2001 to 2023, it appears those complaints have fallen on deaf ears.  On […]
CMS Proposes Stricter Requirements for Payers Under No Surprises Act 
CMS Proposes Stricter Requirements for Payers Under No Surprises Act 

Sarasota, FL (WorkersCompensation.com) - Earlier this year, testimony presented to the House Committee on Ways and Means, showed that the number of healthcare provider bankruptcies increased 84 percent from 2021 to 2022. Although workforce shortages […]
Physicians Urge Congress to Stop Proposed Pay Cuts For 2024
Physicians Urge Congress to Stop Proposed Pay Cuts For 2024

Sarasota, FL (WorkersCompensation.com) – Earlier last week, CMS announced a proposed 3.34 percent decrease in the 2024 Conversion Factor that is used to calculate physician payments. According to a history from the American Medical Association […]
OIG Audit Report Finds $888.2 Million in Overpayments for Genetic Testing Code
OIG Audit Report Finds $888.2 Million in Overpayments for Genetic Testing Code

Sarasota, FL (WorkersCompensation.com) – Let’s face it, medical billing is complicated! The regulations and payer rules change on a daily basis, and the volume of information reviewed and regulated is astounding, with incorrect claims easily […]
Study Finds Disparities in Patients Having Knee Replacement in ASCs
Study Finds Disparities in Patients Having Knee Replacement in ASCs

Sarasota, FL (WorkersCompensation.com) – In 2018, the Centers for Medicare & Medicaid Services (CMS) removed Total Knee Arthroplasty (TKA) procedures, also known as total knee replacement, from the Inpatient Only List, allowing the procedures to […]