Search Our Site
The Health Law Partners TV
Recovery Analytics
The Council for Certification of Medical Auditors (CCMA)
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
Posted in Finally Friday!
Tagged chargemaster audit, mac audit, mac reviews, MACs, tpe
Leave a comment
“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
Posted in Finally Friday!
Tagged 48-hour rule, abby pendleton, ama lawsuit, appeal academy, bill malm, CMS, craneware, finally friday, health law partners, jessica gustafson, mac audit, MACs, oig report, probe and educate, RAC, recovery analytics, recovery audit contractor, ron hirsch, sharon easterling
Leave a comment
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
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
Posted in Academy Blog
Tagged 2 midnight policy, 2 midnight rule, aha, ama, CMS, CMS-1599, compliance, IP admission, IP benchmark, ipps final rule fy2014, MACs, RAC, RAC Audits, recovery audit contractor
Leave a comment
“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