The federal government has intervened in a whistleblower lawsuit alleging that a large hospitalist company systematically overbilled government health programs, the U.S. Department of Justice announced Monday.
The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, according to Acting CMS Administrator Marilyn Tavenner.
Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.
The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, Acting CMS Administrator Marilyn Tavenner said Tuesday.
The Office of the Inspector General's recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.
Nursing home advocates are expected to kick into high-gear defense mode after a new federal report asserted Tuesday that providers are overcharging Medicare to the tune of $1.5 billion annually.
Medicare providers increasingly are using higher-paying codes instead of using less complex, lower-paying codes, an investigation has found. This practices, known as "upcoding," has added $11 billion or more to their fees over 10 years.