tci Medicare Compliance & Reimbursement - 2006 Issue 28
INDUSTRY NOTES: Medicare Turns Your Imaging Services Reimbursement Upside-Down
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Article Overview
This article surveys several current health care policy and compliance developments affecting Medicare, Medicaid, hospice, and accreditation-related operations. It focuses on payment and coverage changes, federal rulemaking activity, litigation over Medicaid eligibility documentation, fraud enforcement, and selected administrative guidance relevant to providers and compliance teams.
Why This Topic Matters
It helps providers, billers, compliance staff, and analysts track high-impact federal changes that can affect reimbursement, documentation, eligibility, and operational requirements across multiple care settings.
Article Sections
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Medicare imaging services reimbursement changes
Discusses federal policy activity affecting imaging service payment under Medicare, including agency and congressional developments and timing of rulemaking. It also summarizes the general scope of the payment reforms and where they fit within broader Medicare payment policy.
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Lawsuit follows new Medicaid citizenship documentation rule
Covers a legal challenge and related policy response concerning new Medicaid citizenship documentation requirements. The section addresses the rulemaking timeline, affected populations, and comments from consumer advocacy organizations and federal agencies.
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National hospice provider pays out $12.9 million for Medicare fraud
Summarizes a federal settlement involving hospice billing allegations and related enforcement activity. It also notes the role of whistleblower litigation and a corporate integrity agreement.
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In other news
Collects brief updates on survey guidance, accreditation requirements, premium and payment trends, contractor correspondence, and interest rates. These items are presented as separate operational notices for providers.
What You Will Learn
- The general direction of Medicare imaging payment reforms and rulemaking activity.
- How Medicaid citizenship documentation policy changes are affecting eligibility and litigation.
- What the hospice fraud settlement and related enforcement actions involved at a high level.
- Which additional Medicare, survey, and accreditation updates are highlighted in the industry notes.
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Health care administrators
- Medicare and Medicaid providers
- Revenue cycle professionals
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