Medicare Compliance & Reimbursement

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Complete Coverage of the Latest Medicare Compliance and Reimbursement News

As you start off yet another challenging year, you need to know how CMS’s new policies and rules for 2018 will affect your practice and your reimbursement. Whether it’s the Medicare Physician Fee Schedule, OIG target areas and monthly work plans, CMS-855 form revisions, Conversion Factor changes, new Telehealth Code Options, or QPP updates that will affect your bottom line, knowing what the updates are will allow you to budget and plan effectively. 

But CMS isn’t your only worry! OIG’s 2017 Semiannual Report recorded a plethora of criminal and civil suits, exclusions, and recoveries in the billions. Look at the breakdown for FY 2017, according to the report:

  • Recovered funds: The OIG recouped $4.13 billion in investigative recoveries.
  • Criminal actions: The federal watchdog found 881 individuals or entities guilty of crimes against HHS programs.
  • Civil actions: Civil suits were brought against 826 individuals or entities for fraudulent activities.
  • Exclusions: The OIG also banned 3,244 individuals and entities from participating in federal healthcare programs in the future.


This means you need to be careful if you want to avoid billing errors and stay off the OIG hit list. Missing a single update, whether it’s a fee schedule change, a new form, or an added documentation requirement could cost you big money.

Don’t Worry — Medicare Compliance & Reimbursement Can Help!

Plus, CMS’s new program “Patients Over Paperwork” helps streamline your administration, but that doesn’t mean the QPP Year 2 will be any easier. In fact, MIPS reporting jumps from 90 days to a full year in 2018—are you ready to report your data on day one? Keep abreast of the latest updates and regulations today and avoid unpleasant payback requests tomorrow.

Let editor Kristin J Webb-Hollering arm you with the Medicare compliance and reimbursement information you need to stay informed, compliant, and profitable in 2018 and beyond. Just subscribe to our monthly newsletter: Medicare Compliance and Reimbursement.

TOPICS COVERED IN RECENT ISSUES OF Medicare Compliance & Reimbursement: 

  • Enforcement: Data Analysis Drives OIG's Biggest Takedown Ever
  • Compliance: Combat the 10 Most Common Claims Mistakes with This Expert Advice
  • Reimbursement: Know These 5 Important Dates to Keep Medicare Pay on Target
  • CMS Nixes Some Mandatory Bundled Payments for 2018
  • MACRA: Deadline Alert: Report MIPS 2017 Data to Avoid 4% Penalty
  • New Programs, Delays, and Reductions Feature in the 2018 Fee Schedule
  • Who Were the Winners and Losers in the 2018 Medicare Physician Fee Schedule?
  • Reimbursement: Know These MACRA Updates to Ensure QPP Year 2 Pay
  • Know These Medicare Remittance Rules for Deductibles and Coinsurance
  • E/M Coding: Master E/M Claims with Advice from Part B MACs
  • CPT® 2018: Brace Yourself for 5 Major Coding Changes Effective Jan. 1
  • Advancing Care Information: Find Out What's New in 2018
  • HIPAA: Ensure Internal Protocols Are Ironclad to Stamp Out PHI Exposure
  • Compliance: OIG Settlement Reveals Critical Need for EHR Vendor Vetting
  • Double-Check Appeals’ Requests and Jurisdiction, MAC Urges
  • Hospices Need Increased Physician Involvement, OIG Warns
  • OIG Continues to Hand Out Steep Penalties for Upcoding and False Claims
  • Non-Physician Practitioners: Append Modifier SA on NPP Claims Now or Risk Denials, One Private Payer Says
  • Keep on Top of the Medicare Card Number Transition
  • Enforcement: Data Analysis Drives OIG's Biggest Takedown Ever
  • Compliance: Combat the 10 Most Common Claims Mistakes with This Expert Advice
  • Know These 5 Important Dates to Keep Medicare Pay on Target
  • Keep Phishers at Bay in 2018 with These 7 Tips
  • CMS Nixes Some Mandatory Bundled Payments for 2018
  • And much more…


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As a Medicare Compliance and Reimbursement subscriber, you get the coding industry’s hottest resources at no extra cost:

  • Medicare Compliance & Reimbursement Archive (1 Year access): Get your latest issue before it even goes to press with access to this keyword-searchable database of your newsletter content. A $199.95 value.
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Subscribe now to Medicare Compliance & Reimbursement for just $249 to get the guidance and advice you need to stay informed, compliant, and profitable!
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