Date archive: February 2014

CMS Calls for review of “Two-Midnight” Denials

CMS has ordered the Medicare Administrative Contractors (MACs) to re-review all denied claims for admissions under the “two-midnight” rule.  The Final Rule CMS-1599-F has proven to be difficult to implement.  On 2/24/14, CMS issued new guidance, whereby CMS is waiving the timeframe for filing redetermination requests for appeals received before 9/30/14 for claims denied before…

HIPAA Audits – Not a Question of if, but When

Susan McAndrew, Office of Civil Rights deputy director for health information privacy spoke at the HIMSS Conference on 2/24/14. As the OCR already made known, it plans to resume its HIPAA compliance audit program this year following the Pilot HIPAA Audit program in 2012. Now, more information is available on the progress towards the start of those…

Anti-Kickback Law is serious – DaVita to pay $389 million to settle anti-kickback claims

DaVita HealthCare Partners said it will pay $389 million to settle criminal and civil anti-kickback investigations and plans to end joint ventures with kidney doctors involving 28 dialysis clinics.  A statement DaVita released Tuesday said the settlement will include payment of about $389 million, the appointment of an independent compliance monitor and new restrictions on…

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