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Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs

This study continues OIG's body of work examining overpayments made by Medicare. Overpayments can be identified by a number of key players including providers and Medicare contractors. Recovering overpayments is critical to reducing improper payments in the Medicare program. Past OIG work found that overpayments referred by program safeguard contractors (PSCs) for collection did not result in significant recoveries to the Medicare program. As of 2012, CMS had transitioned the workload of most PSCs to six zone program integrity contractors (ZPICs). In 2016, CMS began transitioning the remaining PSCs ...

Your Online Reputation Is Costing You A Fortune. Here’s Why.

In today’s technology-driven world, people check the internet for reviews before trying any product or service - including doctors. Physicians often overlook their online reputation but this is a huge mistake. Even a slightly negative online reputation can cost you a fortune. Believe it or not, nearly three-quarters of your patients will search for you online before ever calling in to make an appointment! Do you have the best online reputation possible? If not, you are costing yourself money everyday. A poor online reputation leads to lost patients and lost ...

Latest Attempt at Repeal and Replace Falls Short

Republican efforts in Congress to “repeal and replace” the federal Affordable Care Act are back from the dead. Again. While the chances for this last-ditch measure appear iffy, many GOP senators are rallying around a proposal by Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), along with Sens. Dean Heller (R-Nev.) and Ron Johnson (R-Wis.) Read More...

Anthem’s Prediction of 30% Rise in Drug Costs for 2018 Raises Questions

Health insurance giant Anthem predicts Californians will pop a lot more pills next year. To make the case for a hefty premium hike in the state’s individual insurance market, Anthem Blue Cross has forecast a 30% jump in prescription drug costs for 2018. Such a sharp increase is nearly double the estimates of two other big insurers, and it runs counter to industry trends nationally. Read More...

Updated Editing of Always Therapy Services - MCS

This MLN Matters Article is intended for therapists, physicians, and certain other practitioners billing Medicare Administrative Contractors (MACs) for therapy services provided to Medicare beneficiaries. Services furnished under the Outpatient Therapy (OPT) services benefit – including SpeechLanguage Pathology (SLP), Occupational Therapy (OT), and Physical Therapy (PT) – are subject to the financial limitations, known as therapy caps, originally required under Section 4541 of the Balanced Budget Act (1997). Read the entire article