Tag Archives: MACs

“Finally Friday!” The New MAC Medical Review Strategy – Part 2

Friday, September 8 2017 Part 2 of Our Special Series The New MAC Medical Review Strategy: Increased Data Analysis & TPE …Or… How Changes to the Medicare Program Integrity Manual Will Affect You, What these New Audits Will Focus On, … Continue reading

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“Finally Friday!” MAC Probes, AHA Lawsuits, and OIG Reports on E/M

Bill Malm of Craneware reviews some new OIG Reports, foreshadowing perhaps a flood of E/M Audits by CMS contractors. We also hear from Dr. Ron Hirsch of Accretive PAS about some of the insanity coming out of the MACs in Probe and Educate. Jessica Gustafson and Abby Pendleton from The Health Law Partners give us some legal perspective on the OIG postings, and a short review of the recent AHA filing of a mandamus complaint – a filing seeking a judicial remedy to require CMS to “meet statutory deadlines for administrative review of denials” for Medicare claims. Continue reading

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News from the Week of February 28

The Pause Expands Last Month, CMS extended the pause (I refuse to call it a moratorium) on RAC reviews of Medicare claims under the  2 Midnight Rule to a full year, from Oct. 1, 2013 to Sept. 30, 2014. MACs, … Continue reading

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News & Opinion from the Week of November 3 – 9, 2013

AHA and AMA to CMS Re: Two-midnight Policy Inpatient Admission and Review Criteria The AHA and the AMA issued a joint letter to CMS Administrator Marilyn Tavenner on Friday, January 8, in a rare show of combined agreement and support … Continue reading

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“Finally Friday!” New Nightmare: Request for Restriction in HIPAA Omnibus Rule

This session was recorded on Friday, June 28, 2013. Today’s show discusses a little known part of the new HIPAA Omnibus Rule, published in January, which took effect in March, and is likely to BITE your hospital or practice or … Continue reading

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