Policies and Procedures, Centers for Medicare & Medicaid Services (CMS), Audits

Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials

Husch Blackwell LLP on 6/25/2025

In an audit, election statement deficiencies can be costly. Auditors deny all claims covered by the problematic election statement, and those costs can multiply if more than one patient was affected. In this episode, Husch...more

This New Year, California Imposes Guardrails on the Use of AI by Payors for Utilization Management Determinations

Proskauer - Health Care Law Brief on 12/24/2024

SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management. As discussed in a...more

OIG Audit Finds Medicare Overpaid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

King & Spalding on 8/30/2024

On August 12, 2024, OIG announced the results of an audit of payments made to hospitals for inpatient claims with the Medicare Severity Diagnosis-Related Groups (MS-DRGs) that require ninety-six hours of consecutive...more

Policies and Procedures › Centers for Medicare & Medicaid Services (CMS) › Audits

Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials

This New Year, California Imposes Guardrails on the Use of AI by Payors for Utilization Management Determinations

OIG Audit Finds Medicare Overpaid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

OIG Audit Finds That Providers Did Not Always Comply with Federal Requirements When Claiming Medicare Bad Debts

Federal Authorities Place Cardiovascular Stress Testing Under the Microscope

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

Policies and Procedures › Centers for Medicare & Medicaid Services (CMS) › Audits

Hospice Insights Podcast - Election Inspection: Be Proactive to Avoid Costly Election Statement Denials

This New Year, California Imposes Guardrails on the Use of AI by Payors for Utilization Management Determinations

OIG Audit Finds Medicare Overpaid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

OIG Audit Finds That Providers Did Not Always Comply with Federal Requirements When Claiming Medicare Bad Debts

Federal Authorities Place Cardiovascular Stress Testing Under the Microscope

Seven Points to be Aware of for Durable Medical Equipment Company Compliance

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