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Compliance Risks Associated with Outlier Payments 

YouCompli

This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). However, there are certain circumstances when Medicare, for example, will reimburse additional amounts beyond the prospective payment rate.

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OIG Issues Highly Anticipated Industry Segment-Specific Compliance Program Guidance for Nursing Facilities

Hall Render

OIG called for nursing facilities to take proactive measures to ensure compliance with program rules, including conducting regular reviews to ensure billing and coding practices are current and accurate, as well as performing regular internal billing and coding audits. Compliance Officer Experience. Competency-Based Training.

Nurses 40