Hospice audits can have profound financial implications, particularly when the auditors use statistical extrapolation to identify an overpayment amount. The use of extrapolation runs across auditor types, including UPICs and...more
The Affordable Care Act mandated that the Centers for Medicare and Medicaid Services (“CMS”) establish risk categories for Medicare enrollment, which are used by CMS to determine what level of scrutiny to give provider...more
The hospice election may be the single most important document for hospices since an invalid form can impact payment for a patient’s entire stay. Especially in light of a recent rise in Medicare claim denials related to the...more
Medical reviews to restart-
The Centers for Medicare & Medicaid Services (CMS) medical review activity suspended due to COVID-19 is set to restart on August 3, 2020, regardless of the public health emergency status....more