tci Medicare Compliance & Reimbursement - 2009 Issue 1

IN OTHER NEWS ...• CMS is keeping the heat on

• CMS is keeping the heat on home health agencies in South Florida over abuse of outlier payments. The agency suspended payment for 10 HHAs in October over outlier issues, CMS finally officially announced in a Dec. 29 press release. CMS hasn't suspended any more Miami-area agencies' payments, but it is zeroing in on questionable physician relationships to get at the problem. CMS is "implementing extensive pre- and post-payment review of claims submitted by ordering/referring physicians" and "validating claims submitted by physicians who order a high number of certain items or services by sending follow-up letters to these physicians...

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