B. Scott McBride

B. Scott McBride

BakerHostetler

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CMS Announces Changes to RAC Program; Temporary Pause in Document Requests

The Centers for Medicare & Medicaid Services (CMS) recently published an announcement indicating that the agency is “in the procurement process for the next round of Recovery Audit Program Contracts” and is winding down its...more

3/7/2014 - CMS Document Requests Healthcare Healthcare Reform RACs

CMS Proposes Increased Rewards for Reporting Fraud and Abuse

The Centers for Medicare and Medicaid Services (CMS) recently published a proposed rule modifying certain provisions in their Incentive Reward Program (IRP) to sweeten the incentives for reporting sanctionable conduct....more

5/7/2013 - CMS False Claims Act Fraud HIPAA Incentives Reporting Requirements Whistleblowers

CMS Addresses Hospital Rebilling After Inpatient Denials Through Interim Administrator Ruling and Proposed Rule

On March 18, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register two important documents addressing the hotly contested issue of a hospital's ability to obtain payment under Part B for...more

3/22/2013 - Billing CMS Denial of Benefits Healthcare Hospitals Medicare

Annual Report Shows Meteoric Rise in RAC Activity

On February 5, 2013, CMS issued its mandatory Recovery Audit Contractor (RAC or Recovery Auditor) program annual report, detailing overpayments, underpayments, RAC performance and savings to the Medicare program. According to...more

2/27/2013 - ALJ Audits CMS Medicare Overpayment Recovery Audit Contractor

Health Law Update — January 10, 2013

In This Issue: - Healthcare Provisions in the American Taxpayer Relief Act - the Good, the Bad and the Ugly - American Taxpayer Relief Act Amends Overpayment Recovery Time Limits - OIG Advisory Opinion Sheds...more

1/14/2013 - American Taxpayer Relief Act CMS Data Breach Electronic Medical Records Fraud Healthcare OCR OIG Overpayment Recovery Time Limits Pay-for-Performance Reporting Requirements Settlement

ALJ Appeals Frequently Favorable To Providers; OIG Calls For Reforms

The OIG recently published a report reviewing the implementation of 2005 regulations regarding the administrative law judge (ALJ) level of appeals, the third level of the Medicare appeals system. The 2005 regulatory changes...more

12/11/2012 - ALJ Appeals CMS Medicare OIG

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