COVID-19 Hospice How-To Series: Recent Developments Regarding Telehealth, Virtual Visits, and Medicare Audits and Appeals
COVID-19 Hospice How-To Series: Insights and Strategies for Virtual Visits, Telehealth and Medicare Appeals
Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, and errors during Medicare...more
Targeted Probe and Educate (TPE) audits have recently become a common tool used by both law enforcement and private insurers in the Medicare program. While they focus on educating Medicare providers about proper billing...more
Although newly released data from the Office of Medicare Hearings and Appeals (OMHA) suggests that the Medicare claim appeals backlog might be decreasing, OMHA's case processing time and recent litigation challenging the...more
Change is fast-paced in the world of COVID-19. On Monday, March 30th, CMS released an interim final rule along with hospice specific waivers. The Husch Blackwell Hospice Team discusses these recent developments and their...more
In today’s episode, Husch Blackwell's Hospice team shares insights on operationalizing recent government guidance for hospices facing coronavirus obstacles. We discuss the role of virtual visits, how to use telehealth and the...more
When ruling that notice-and-comment procedures may be required for Medicare guidance, the Supreme Court may not have foreseen the potential disruptive impact on Medicare coverage rules....more
Report on Medicare Compliance 28, no. 40 (November 11, 2019) - CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in these procedures as part...more
In the wake of its recent efforts to settle claims (see the 2014 initial hospital inpatient settlement and the 2016 second-round wave), in the heavily backlogged Medicare administrative appeals system, CMS has introduced a...more
On November 1, 2018, the United States District Court for the District of Columbia (“District Court”) issued an order and memorandum opinion addressing the government’s current backlog of administrative appeals for Medicare...more
The Office of Medicare Hearings and Appeals (OMHA) has announced the expansion of their Settlement Conference Facilitation (SCF) program. ...more
A recent ruling allows health care providers to seek relief from federal courts if the delay caused by the Medicare appeals backlog is likely to cause the provider irreparable injury....more
On March 27, 2018, the United States Court of Appeals for the Fifth Circuit held that a health care provider can seek an injunction in federal court against recoupment by Medicare of alleged overpayments despite not...more
Recently HHS announced two initiatives to address the mounting Medicare appeals backlog at the Administrative Law Judge level: (i) expand the Settlement Conference - Facilitation (SCF) program and (ii) offer a new Low...more
The LVA settlement option is being offered to providers and suppliers with fewer than 500 Part A and B claims pending as of Nov. 3, combined, where no single claim appeal exceeds $9,000. These appeals will be settled at 62...more
In November 2017, the Department of Health and Human Services (HHS) announced new settlement options for providers and suppliers stuck in the backlog of the Medicare appeals process. One of the new options available is the...more