The AIS Guide to Blue Cross and Blue Shield Plans: 2010

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Articles on
Compliance Strategies

Government Resources
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Stories are listed in chronological order,
with the most recent appearing first.

CMS RAC Chief: Medical-Necessity Audits Are Coming, Will Be ‘Big Mountain to Climb’ for Hospitals
CMS Revs Up Its Process of Terminating Providers From Medicare and Medicaid 
Providers Have Won Majority of RAC Claims Denials They Have Appealed 
To Fight Retaliation Against Employees, Monitor Staff Who Report Compliance Issues 
CMS Gives ‘Mixed Signals’ in New Physician Supervision Guidance
One Extra Football Ticket Can Push a Hospital Over the Stark Non-cash Cap
New CMS Regulations Raise Enforcement and Financial Risks for Medicare Advantage and Part D Plans 
Hospital Pays $108 Million to Settle False Claims Allegations Over Patient Access
The Scoring of Audits Gets Docs’ Attention and Takes Advantage of Their Competitiveness 
The Human Hotline: Compliance Officer Handles Most Calls and Problems Directly
Health Reform Mandates Will Drive Measurement of Compliance Effectiveness, Quality of Care
Feds Allege Nursing Home Owners Provided ‘Worthless Services’ 
Electronic Health Records Open Brand-New Cans of Compliance Worms for Hospitals
Enrollment Watchdogs Target all Medicare Providers With Expanded Screening Powers 
Swept Up in Major Medical Device Case, Physician Pays $650,000 to Settle Kickback Charges 
Health Reform Means Major New Medicaid Integrity Provisions and Changes for Providers
Hospital, M.D. Are Accused of Harming Patients in Quality-Driven False Claims Act Case 
Workload, Responsibility of Compliance Departments Grow With Heightened Government Enforcement 
AHIMA: Physician Query Constraints Should Be Same for Coders and Clinical Documentation Improvement Specialists
The HHS Office of Inspector General Is Weighing a National Probe of Entities That Bill Medicare for Excluded Providers

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