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medical necessity

Hyperbaric Oxygen Therapy Services: 2017 OIG Work Plan Initiative Finds 85 Percent of Claims Billed in Error


Posted on April 26, 2018 in Health Law News

Published by: Hall Render

On February 15, 2018, the Office of Inspector General (“OIG”) released a report announcing the results of a review it conducted of outpatient hyperbaric oxygen therapy (“HBO therapy”) claims. Of the 120 sampled outpatient claims under review, OIG found payment was made in accordance with Medicare requirements for only 18 claims. The audit, included... READ MORE

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Updates to Hospice Face-to-Face Encounters


Posted on July 1, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

In response to the changes contained in the Patient Protection and Affordable Care Act (ACA) designed to address increasing lengths of stay in hospice programs, CMS added a “face-to-face encounter” requirement to the hospice certification requirements. Effective January 1, 2011, a hospice physician or nurse practitioner must have a “face-to-face” encounter with each hospice... READ MORE

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