Tag Archives: medical audit

Self-Administered Medication – Earned Revenue or Another Write Off

Caveat emptor et provisor [Let buyer and provider beware] Written by Bill Malm, ND CMAS CRCR Many facilities struggle with the implementation and collection of earned revenues from Self-Administered Medications (SAD.)  SAD has had a litany of guidance made by … Continue reading

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“Finally Friday!” CMS Proposes the MOON & Other Changes for the NOTICE Act

FRIDAY May 13, 2016: “CMS Proposes the MOON & Other Changes to Implement the NOTICE Act“ A Proposed Rule Inside A Proposed Rule OR How CMS can defy Congress with a straight face Get the Handouts Sponsored by The Health … Continue reading

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CMS Temporarily Pauses Two-Midnight Reviews by QIOs

Reasoning Unclear, Time-frame Indeterminate Audits of Medicare claims concerning the Two-Midnight Rule are temporarily suspended by CMS, to allow CMS to collaborate with the two BFCC-QIO contractors, Livanta and KEPRO, “to ensure consistency in how the rule is applied to … Continue reading

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CMS Proposes MOON for the NOTICE Act in FY2017 IPPS Proposed Rule

One of many changes floated in the FY2017 IPPS Proposed Rule CMS introduced a standard notice to be given to observation patients after 24 hours as such, the “Medicare Outpatient Observation Notice” (MOON) that would include all of the informational … Continue reading

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CMS Offers the MOON to fulfill NOTICE requirements

CMS has developed a standard notice, the “Medicare Outpatient Observation Notice” (MOON) that would include all of the informational elements necessary to fulfill the NOTICE Act’s written notice requirement. Continue reading

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“Finally Friday!” Can You Get Medicare to Pay for Surgery Prep?

Is Gray the New Black? Can You Get Medicare to Pay for Surgery Prep? Watch the Replay and Get the Handouts Since there was a lot of discussion this week on the rac-relief Google Group about how to handle cases … Continue reading

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“Finally Friday!” Will CMS or Congress Kill Medicare’s 3-Day Qualifying Stay for SNF Coverage?

3-Day Stay for SNF Coverage: Will It Stand or Not? Regs Review & Another Quiz from Dr. Pahuja Plus: Interview with a Physician Advisor Double Certified as a Medical Auditor In a previous week, we heard from two practicing Physician … Continue reading

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