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Have you noticed how healthcare headlines* are increasingly reporting
the impact of the government's bevy of bounty hunters?
Fraud and Abuse is
seriously under attack by
Recovery Audit Contractors (RACs), Medicare Administrative Contractors (MACs),
Medicaid Integrity Contractors (MICs), and Zone Program Integrity
Contractors (Z-PICs). And now, with the latest teaming of
HSS and
the U.S. Department of Justice, the new Health Care Fraud Prevention and
Enforcement Action Team (HEAT), whose sole mission is to investigate and
work to eliminate fraud in healthcare.
Already RACs have raked in $1.3 billion with their
initial target being CMS' Part A expenditures in hospitals, but now
they're expanding their scope and starting to move through the other
Parts of the CMS alphabet.
Our Featured Member, Ed Buckley, President and CEO of
Select Data Inc., will give us examples of what all this means for
anyone concerned about "Revenue Cycle Management" (or just plain getting
paid), and how it's playing out in several of the major healthcare
sectors today - and is likely to expand in the near-term future. And
we'll look to hear what you have been hearing (or even
experiencing), too.
Ed will also look for your thoughts as we discuss
the best positioning for - and ways to "educate" the market as to the
soundness of - his "Clinically-Driven Approach to Revenue Cycle
Management," that is both compliant, and bills the maximum
allowable charges, for services actually performed.
Since we've been assured that one of the ways we're going to ensure
budget neutrality under Reformed Healthcare is going after Fraud &
Abuse, I'm sure you'll want to be with us for this enlightening
session.
*SEC Investigates Home-Health Companies
- The Wall Street Journal, July 2, 2010: Home-health-care
providers Amedisys Inc. and Almost Family Inc. said they are now the
focus of an investigation by the Securities and Exchange Commission, a
month and a half after the U.S. Senate began inquiring into their
Medicare-reimbursement practices. The investigation is related to the
SEC probe, which revolves around whether the companies pushed patients
into extra, sometimes unnecessary, home-health care visits in order to
hit a threshold level that secured them thousands more in reimbursements
from the government's health-care program….Two other peers, Gentiva
Health Services, Inc. and LHC Group, were both involved in the Senate
inquiry.
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