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Credible Information Is Heart of 60-Day Rule; OIG: Self-Disclosure Pauses the Clock | Health Care Compliance Association (HCCA)

Credible Information Is Heart of 60-Day Rule; OIG: Self-Disclosure Pauses the Clock | Health Care Compliance Association (HCCA)
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CMS Budget Justification Requests Increased Audit and Appeals Funding | Baker Ober Health Law

CMS Budget Justification Requests Increased Audit and Appeals Funding | Baker Ober Health Law
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Report on Medicare Compliance Volume 30, Number 8. News Briefs: March 2021 | Health Care Compliance Association (HCCA)

According to a CMS spokesperson, “
CMS has not yet determined when Targeted Probe and Educate reviews will resume.” Meanwhile, “CMS continues to temporarily pause the performance of retroactive short-stay reviews to reduce burden on providers for consistency with COVID-19 waivers,” the spokesperson told
RMC. Livanta, a beneficiary and family-centered care quality improvement organization, performs “retrospective reviews of Medicare Part A claims to ensure care provided by the Medicare program is medically necessary and reasonable, meets professionally recognized standards, and is provided in the appropriate setting.” It’s unclear when they will be back. Livanta also reviews higher-weighted DRGs, the spokesperson said. ....

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