MRO Compliance
JANUARY 16, 2025
2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Below we will discuss some strategies for payers to overcome these challenges and rest assured that they are doing all they can to innovate and change in 2025. This is why payers are now shifting toward pre-pay accuracy.
Health Law Advisor
FEBRUARY 2, 2023
For these years, CMS will limit payment recoveries to “enrollee-level adjustments,” i.e., the non-extrapolated overpayments identified in CMS RADV audits and Department of Health and Human Services Office of Inspector General (OIG) audits. million per year starting in 2025 for PY 2018 from extrapolated recoveries.
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Hall Render
JANUARY 10, 2025
On January 1, 2025, the Centers for Medicare and Medicaid Services’ (“CMS”) new 60-Day Rule became effective. However, under the updated rule, the obligation to report and return an overpayment begins upon identification, even if the exact amount is undetermined. The rule is codified at 42 U.S.C. 1320a-7k(d).
AIHC
FEBRUARY 17, 2025
There are also self-reporting mechanisms in place to report overpayments on the OIG website ( Self-Disclosure ) and Self-Referral Disclosure for voluntary self-reporting of overpayments on the Centers for Medicare and Medicaid Services (CMS) website.
Hall Render
DECEMBER 11, 2024
ET on January 31, 2025. Post-acute compliance teams should also determine whether to submit a comment to support, question, clarify or challenge any of the proposed changes. Comments are due by 5:00 p.m.
Healthcare Law Blog
JANUARY 5, 2023
The Proposed Rule includes changes on an array of topics including: Star Ratings, medication therapy management, marketing and communications, health equity, provider directories, coverage criteria, prior authorization, behavioral health services, identification of overpayments , requirements for valid contract applications, and formulary changes.
Healthcare IT Today
JANUARY 13, 2025
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
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