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Also in the News for Friday, Feb. 16

Family’s in-room camera leads to elder abuse charges against two nursing home aides … Pennsylvania aide, nursing student pleads in nursing home abuse case, drops plan to sue facility and college … Latest review: Security gaps in Medicare Administrative Contractor IT systems up 8 percent

NASL's Cynthia Morton

GAO: Review process rushed

Medicare Administrative Contractors started a manual review process for outpatient therapy claims too quickly, setting the stage for chaos in late 2012, a government review has revealed.

Sen. Tom Coburn (R-OK)

Bill calls for faster action on RAC reports, more ‘expert’ Medicaid oversight

The Centers for Medicare & Medicaid Services should move faster to make changes based on Medicare audits and should have more direct oversight over Medicaid, according to bipartisan legislation introduced Tuesday. “The Preventing and Reducing Improper Medicare and Medicaid Expenditures Act of 2013” proposes a variety of reforms to cut down on waste, fraud and abuse. The PRIME Act was introduced by Sens. Tom Carper (D-DE) and Tom Coburn (R-OK), and Reps. John Carney (D-DE) and Peter Roskam (R-IL).

AHCA/NCAL President and CEO Mark Parkinson

AHCA opposes manual review system for therapy claims, launches provider feedback clearinghouse

As part of its pushback against the manual review process for therapy claims, the American Health Care Association has launched a clearinghouse to gather provider feedback. AHCA President Mark Parkinson described the RAC-led review process as “bifurcated, confusing and wholly inappropriate” in a four-page letter sent to Acting CMS Administrator Marilyn Tavenner last week.

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