tci Medicare Compliance & Reimbursement - 2008 Issue 36

Reimbursement: Feds' Fraud Fight Will Reduce Outlier Rate

CMS punts on wage index yet again. The 2009 home health agency rate update notice does contain one piece of good news in an unexpected area. Under the current 0.89 fixed dollar loss (FDL) ratio for outlier calculations, the Centers for Medicare & Medicaid Services expects outlier payments to reach 8.1 percent in 2008. That's well above the 5 percent they are supposed to make up, CMS points out in the 2009 PPS rate update notice in the Nov. 3 Federal Register. If CMS kept the current FDL ratio and provider payment patterns stayed the same, outlier...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.