“Finally Friday!” Chasing Regs, CMS Education and MA Plan Denials

FRIDAY January 29, 2016:

“Chasing Regs, CMS Education and MA Plan Denials”

Sponsored by The Health Law Partners, Medlinks, Aerolib, Recovery Analytics, and the Council for Certification of Medical Auditors


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This week, we hear from Dr. Ron Hirsch of Accretive PAS, as he reviews an article he recently wrote on how CMS keeps changing auditing rules, willy nilly, and how it makes it even harder for hospitals to bill for reimbursements accurately and appropriately. Doesn’t it feel like they (CMS) really doesn’t want you to be able to keep up?

Despite recent interactions with the new short-stay auditors, the BFCC-QIOs, which have been much better than interactions with Recover Audit Contractors, the changes and rather ambiguous sub-regulatory guidance offered to all parties by CMS seems to make the situation almost impossible to resolve. To illustrate, Dr. Larry Field joins us to relate his adventures in appealing denials from the Medicare Advantage plans.

So, this week, we review these topics:

  1. Confusion in the CMS website, QIO webinars and OPPS
  2. Difficult denials emanating from the MA Plans (go figure)
  3. And will the new plans for Drug Price Controls see enactment?

So listen in, share your own insights and bring your questions for us!

Tune in on Friday, same Bat Time, same Bat Channel…

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