Part B News | Editors' Blog

Expert input: Proposed changes to safe harbors and exceptions are designed to break barriers to value-based care

by: William Maruca Oct 10, 2019

As part of an effort entitled the Regulatory Sprint to Coordinated Care, CMS and OIG released advance copies of proposed regulatory changes on Oct. 9. The proposed rules would modify regulations that have presented obstacles to physicians, hospitals and other providers as they transition away from traditional fee-for-service (FFS) payment models toward value-based arrangements.

Fake nurse gets 57 months in jail for working at health care facilities without a license

by: Roy Edroso Jun 13, 2019

Benjamin David Danneman, 37, of Eureka, Mo., was employed by at least three local health care organizations that should be conferring with lawyers now. On June 12, Danneman was sentenced to 57 months in prison for working for them as a nurse and, in one case, as an assistant director of nursing without a nursing license.

The $118,000 incident-to incident

by: Julia Kyles, CPC May 21, 2019

A practice that follows the rules for incident-to billing can expect 100% of reimbursement for a non-physician practitioner’s (NPP) services reported under a physician’s provider number, rather than 85% billed under the NPP’s ID. A practice that breaks the rules for incident-to billing can expect trouble.

These 3 cases illustrate how not to bill for therapy services

by: Laura Evans, CPC May 10, 2019

In case you were thinking federal investigators would never be interested in your therapy claims, here are three practices from today's HHS OIG website that would likely disagree.

CCM CEO gets 2 for theft

by: Julia Kyles, CPC May 7, 2019

A conviction for health care fraud isn’t the only criminal penalty that awaits someone involved in Medicare fraud. Theft of government property is another possibility, a recent Department of Justice (DOJ) press release reveals.

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