Feds propose shakeup for emergency room billing

By Fred Schulte

Proposal seeks to counter alleged over-billing with standardized rate

Excerpts from this story referencing "Health":

"… n ObamaCare, Medicare, and public Health.  Sign up now to receive our Health newsletter. ------------------------- Still, the draft CMS fee proposal, …"

"… report. In the wake of the news reports, Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius threatened possible crimina …"

"… flat charge of $88.31. Dr. Kevin Kavanagh, a retired physician who heads Health Watch USA, a patient advocacy group based in Kentucky, said that CMS shoul …"

"… are specialists. Dr. Brent Wallace, chief medical officer of Intermountain Healthcare in Salt Lake City, wrote to CMS on Aug. 6. He argued that the $875 bun …"

Feds 'listen' for sounds of Medicare billing abuse

By Fred Schulte

Baltimore session looks at role of electronic health records in higher medical bills.

Excerpts from this story referencing "Health":

"… ds to overbill Medicare, top government officials swung into action. U.S. Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric H …"

"… order to inflate what providers get paid.” Sue Bowman, of the American Health Information Management Association, said her testimony in Baltimore would …"

Feds tighten scrutiny of health records

By Fred Schulte

Feds increase scrutiny of how electronic systems affect billing

Excerpts from this story referencing "Health":

"… elle Dougherty, director of research and development for the American Health Information Management Association,  said the new directive “will h …"

"… al professionals who made the switch.Yet late last year, the Department of Health and Human Services Office of Inspector General said its contractors had de …"

"… sultant who serves on a panel on fraud and abuse for the trade association Healthcare Information and Management Systems Society, or HIMSS, said that one of …"

Suit alleges retaliation for exposure of upcoding

By Fred Schulte

Nevada woman claims she was fired after questioning hospital's bills

Excerpts from this story referencing "Oklahoma":

"… ing errrors, including one review in March of emergency rooms in Texas and Oklahoma that found $45 of every $100 was “paid in error.” Officials worry that …"

IMPACT: Cabinet officials signal crackdown on Medicare billing abuse

By Fred Schulte and Joe Eaton

Sebelius, Holder signal new scrutiny in wake of Center series

Excerpts from this story referencing "American Hospital Association":

"… d.”Most of the five groups sent the letter on Monday had no comment. The American Hospital Association said it agreed that upcoding should not be tolerated, but added that “mo …"

"… ical review activities.”The five medical groups sent the letter are: the American Hospital Association, the Association of Academic Health Centers, the National Association of P …"

Billing complexity spawns new industry

By Fred Schulte

Thousands now employed as professional coders, but oversight is lacking.

Excerpts from this story referencing "Health":

"… nies nationwide handle billing for doctors and hospitals, according to the Healthcare Billing and Management AssociationBy all accounts, demand is rising. C …"

"… al Coders, founded in 1988, boasts more than 117,000 members. The American Health Information Management Association, which has advocated for accurate medic …"

"… can create an incentive to overcharge, they remain in wide use. But the Healthcare Billing and Management Association contends these deals are “appropr …"

"… oding guidelines assure “there’s going to be a wide range of errors.”Health lawyer and coding expert Miscoe agreed. “Fundamentally, we need to chang …"

Hospitals grab at least $1 billion in extra fees for emergency room visits

By Joe Eaton and David Donald

Center probe suggests facilities have taken advantage of government’s failure to set billing standards.

Excerpts from this story referencing "Health":

"… aid Barbara Vandegrift, a Health care consultant at Tennessee-based Quorum Health Resources. “It’s ‘wait until we get caught and we’ll fight it at t …"

"… ,” said Judith Kelly, director of Health information management at Unity Health System in Rochester, N.Y. To address the issue, Kelly said CMS should issu …"

"… he cut. In 2002, the American Hospital Association (AHA) and the American Health Information Management Association, an association representing Health inf …"

Growth of electronic medical records eases path to inflated bills

By Fred Schulte

Billing software helps medical professionals document higher fees.

Excerpts from this story referencing "vice chairman":

"… cine “has backfired at this point,” said Dr. Robert Berenson, a former vice chairman of MedPac, a commission that advises Congress on Medicare payment issues. …"

How doctors and hospitals have collected billions in questionable Medicare fees

By Fred Schulte and David Donald

Center investigation suggests cost from upcoding and other abuses likely tops $11 billion.

Excerpts from this story referencing "Centers for Disease Control and Prevention":

"… onger and more complex office visits despite annual surveys by the federal Centers for Disease Control and Prevention showing that the average time doctors spent with patients didn’t change …"