decisionhealth Newsletters, Part B News - 2014 Issue 1 (January)
Part B News briefs
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Article Overview
This article summarizes several federal policy and enforcement developments relevant to Medicare, provider compliance, and health coverage administration. It covers changes to an OIG electronic health record donation safe harbor, CMS efforts aimed at providers with persistent audit issues, HHS guidance affecting insurer treatment of providers, and OIG’s stated management and enforcement priorities. The piece is aimed at billing, compliance, and practice management professionals who track regulatory updates.
Why This Topic Matters
These updates can affect how practices evaluate compliance risk, respond to audits, and understand shifting federal enforcement and coverage policy. It is useful for organizations that monitor Medicare program integrity and other federal health policy changes.
Article Sections
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OIG final rule expands EHR donation safe harbor
Discusses a federal rulemaking update affecting electronic health record donation arrangements, including changes to the safe harbor framework and related exclusions and timing changes.
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CMS moves to try to fine, expel “recalcitrant providers”
Summarizes CMS program integrity activity focused on providers with persistent pre-payment review concerns and the agency’s use of Medicare administrative contractor oversight.
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HHS “strongly encouraging” plans to treat providers as in-network
Covers a federal coverage-related communication urging plans to support continuity of care and address network status questions for certain providers.
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HHS’ Office of Inspector General (OIG) releases its top challenges
Reviews OIG’s published management and enforcement challenge areas for the coming year, including broad program integrity and oversight priorities.
What You Will Learn
- What federal agencies are highlighting in recent Medicare and health policy updates
- What broad compliance and enforcement areas are receiving attention from OIG and CMS
- How policy changes may affect provider participation, oversight, and administrative processes
- Which general topics are emphasized in agency priority statements and rule updates
Who Should Read This
- Medical coders
- Billing specialists
- Compliance officers
- Practice managers
- Healthcare administrators
- Revenue cycle professionals
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