Magnifying Glass

CMS’ Delayed Enforcement of Civil Monetary Penalties Provides More Time for Medicare Compliance 
CMS’ Delayed Enforcement of Civil Monetary Penalties Provides More Time for Medicare Compliance 

By Jeff Stinson  In the last several years, the Centers for Medicare & Medicaid Services has instituted a number of changes in its processes and procedures. These changes have affected both the submission and review of Medicare Set-Asides (MSAs) but most notably the reporting […]
Do Work Requirements for Medicaid Work? WCRI Keynote Questions Conventional Wisdom
Do Work Requirements for Medicaid Work? WCRI Keynote Questions Conventional Wisdom

Conference Insights Legislative efforts to get more people working could have an impact on workers’ compensation; after all, getting people on the job means getting those same people under the umbrella of workers’ compensation coverage […]
Receiving Medicaid Benefits for Surgery doesn’t Prevent Workers’ Compensation Claim
Receiving Medicaid Benefits for Surgery doesn’t Prevent Workers’ Compensation Claim

Boise, ID (WorkersCompensation.com) -- If someone receives Medicaid benefits to pay for surgery, does that rule out a case for workers' compensation benefits. Not according to Idaho's top court in Thompson v. Burley Inn, Inc., […]
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 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 […]
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 […]