BRITISH PETROLEUM TO FUND AL MEDICAID- Lawmakers struggling to scrounge up funds to fill the Mcd budget gap have come up with a way to leverage money the state is owed from the BP oil spill. It’s a little tricky for me to understand but it involves a…
via Clay’s Weekly Medicaid RoundUp: Week of April 25th, 2016
The most interesting exchange is at 44:00 in…
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.
CMS should focus its billing audits less on verifying medical necessity and more on rooting out blatant fraud, the agency’s likely next secretary said Tuesday. Rep. Tom Price, R-Ga.
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