"OIG" & "Medicaid" Articles


Click on the title to see the article summary and a link to the full article.


OIG – Fraud and Abuse Study with COVID-19 Testing

|

According to the Office of Inspector General (OIG), “The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example, to confirm or rule out diagnoses ...

OIG Report Highlights Need to Understand Guidelines

|

A new OIG report once again highlights the necessity for organizations to fully understand requirements for reporting services and having proper documentation. The types of problems addressed in this report are ongoing issues for multiple types of services and specialties and for many different payers.

Office of Inspector General Says Medicare Advantage Organizations are Denying Services Inappropriately

|

We attended the recent virtual RISE National Conference and had the opportunity to listen to presenters share their knowledge about risk adjustment and HCC reporting and data validation. Among the presenters were representatives from the Office of Inspector General (OIG), who presented findings from encounter data from 2012-2016. They began ...

Changes in Medicare Advantage and Part D

|

The Centers for Medicare & Medicaid Services finalized several changes in Medicare Advantage and Part D on Friday.  The Trump administration has finalized several changes in Medicare Advantage (MA) and Part D in anticipation of bid submissions on June 1. The Centers for Medicare & Medicaid Services (CMS) released  Friday that includes ...

Now That is Fraud! Genetic Testing "Public alert"

|

Genetic testing is becoming very popular. In fact, so popular you might see it in places you would not expect such as a community event, fairs or any event happening in your community. Some labs may even offer FREE screening for genetic testing. Watch for FREE screening announcements or advertisements ...

More Telehealth Changes Announced by CMS

|

On March 31, 2020, CMS announced further changes to their telehealth program in response to this unprecedented public health emergency (PHE). See this article for further information as well as references & links to CMS information

Changes to Portable X-Ray Requirements

|

On September 30, 2019, CMS published a final rule which made changes to portable x-ray services requirements as found in the law.

The OIG Work Plan: What Is It and Why Should I Care?

|

The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...

An Update on the DHS OIG's Effort to Combat Fraud & Abuse

|

An Update on the DHS OIG's Effort to Combat Fraud & Abuse Every year, the Department of Health and Human Services (DHS) Office of Inspector General (OIG) is required by law to release a report detailing the amounts deposited and appropriated to the Medicare Trust Fund, and the source of such ...

OIG Announces New Review For Medicare Part B Payments for Podiatry and Ancillary Services

|

Due to prior OIG work identifying inappropriate payments for podiatrists and ancillary services, the OIG announced in Feb 2019 they will begin a new review starting in 2020.  The OIG stated they will review Medicare Part B payments to determine if medical necessity is supported in accordance with Medicare requirements.   Part of the ...

What is Medical Necessity and How Does Documentation Support It?

|

We recently fielded the question, “What is medical necessity and how do I know if it's been met?" The AMA defines medical necessity as: It is important to understand that while the AMA provides general guidance on what they consider medically necessary services, these particular coding guidelines are generic and may be ...

Spotlight: Medicaid Information

|

Find-A-Code's information is Medicare based, but did you know we also have Medicaid information? The information can be found under the Topics tab at the top of the Find-A-Code page. Hover over Topics then click States. Click the ALL STATES link at the top of the list. Here you will...


older articles ↓



article requests

If you would like a specific article written on a medical coding and billing topic, please contact us.


contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:


article topics


free demo
request yours today
pricing
for any budget
sign IN
welcome back!

Thank you for choosing Find-A-Code, please Sign In to remove ads.