Report on Medicare Compliance Volume 28, Number 40. (November 11, 2019)
◆ In a new Medicare compliance review, the HHS Office of Inspector General (OIG) said Angels Care Home Health in Salina, Kansas, didn’t comply with Medicare requirements for 29 of the 72 claims that were audited.[1] The overpayment was $57,148, but OIG extrapolated it to $3.8 million for 2014 and 2015. OIG said Angels Care billed Medicare for patients who weren’t homebound or didn’t need skilled services, or the home health agency submitted claims with the wrong Health Insurance Prospective Payment System payment codes. In a letter to OIG, Angels Care disagreed with its findings and contended the “statistical sampling methodology used by the OIG is unreliable and inherently flawed.”
◆ In a new MLN Matters (SE 19005 Revised),[2] CMS explains the types of home health providers that now face greater oversight. “For the provisional period of enhanced oversight authority, ‘new’ providers includes all initial enrollments, changes of ownership (CHOWs) that fall under 42 C.F.R § 489.18, and changes of information reporting a 100% ownership change,” the MLN Matters stated.
◆ The HHS Office for Civil Rights and the Office of the National Coordinator for Health Information Technology have released version 3.1 of the HHS Security Risk Assessment (SRA) Tool. The tool is designed to help small- and medium-sized health care organizations assess security risks and reduce the chance of being affected by malware, ransomware and other cyberattacks. The current version of the SRA Tool includes functionality updates based on public input. New features include threat and vulnerability validation, improved asset and vendor management (multi-select and delete functions added), incorporation of National Institute of Standards and Technology Cybersecurity Framework references, capability to export the detailed report to Excel, addition of question flagging and a Flagged Report, bug fixes and improved stability. Download version 3.1 of the SRA Tool and view the answers to additional questions at https://bit.ly/32faqzK.