Even honest billing mistakes can lead to devastating effects for a health care provider. Take overbilling for example. Health care providers occasionally receive overpayment for Medicare or Medicaid. These issues can easily be resolved with a refund. Unfortunately, if the issue is not fixed quickly then the provider can face serious consequences.
Doctors are extremely busy. In addition to caring for their patients, regulations force healthcare providers to fill out seemingly endless paperwork. Medicare Parts A and B healthcare providers face the additional burden of ensuring, at risk of punishment, that all of their received Medicare payments are correct.
The laboratory industry is undergoing heightened medical scrutiny, both for independent clinical laboratories and physician office laboratories. Expansion into this industry is filled with regulatory risk for violation of state or federal laws. Some of the issues being scrutinized are as follows:
Last week, The Centers for Medicare & Medicaid Services (CMS) published a final rule that will change the way hospices are paid in 2016. In the final rule announced in Federal Register, 80 Fed. Reg. 47142, hospices will receive approximate $160 million more in payment over the 2016 fiscal year.