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Vol. VIII, No. 44 – December 22, 2006 | Contact: Margaret Dragon, Editor, (781) 593-4924
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Table of Contents
Headlines
Ten Arrested on Medicare Fraud Charges
Florida Man is Charged with Medicaid Fraud
No End is Sight at UMDNJ
Health Care Company Owner Charged with Medicaid Fraud
Regulatory News
CMS Updates
In the Federal Register
From the GAO
CMS Transmittals
From the OIG
This Week’s Links
Acronym Library
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Headlines:
Ten Arrested on Medicare Fraud Charges
The December 21 Miami Herald reported that “After a detective worked undercover for months to learn what was happening inside a Hialeah clinic, police on Wednesday arrested 10 people on charges of racketeering and insurance fraud in a scheme that allegedly bilked taxpayers out of more than $1 million.
“The clinic, Rehability of Florida, was shut down in the arrest sweep.
“Another three persons were arrested in New York as part of the alleged conspiracy, Hialeah Deputy Police Chief Mark Overton said.
“The case provides a rare inside look at Medicare fraud, which officials of the Federal Bureau of Investigation estimate costs taxpayers $1 billion a year in South Florida alone.” For more: http://www.miami.com/mld/miamiherald/business/16286341.htm
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Florida Man is Charged with Medicaid Fraud
On December 19 the South Florida Sun-Sentinel reported that “A Pembroke Pines man was charged Monday with running a $39 million Medicaid fraud in which he bought stolen prescription drugs in bulk and then sold them to unsuspecting pharmacies nationwide, according to the Florida Attorney General's Office.
“Authorities are calling the case, which was three years in the making, one of the state's largest in recent years.” For more: http://www.sun-sentinel.com/news/local/palmbeach/sfl-pncfraud19dec19,0,1790531.story?coll=sfla-news-palm
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No End is Sight at UMDNJ
On December 17 The Star-Ledger reported “Last December when he charged the state's medical university with Medicaid fraud and installed a federal monitor to clean the place up, U.S. Attorney Christopher Christie figured the job would be pretty much done by now.
The scandals would stop, the monitor would be moving on, and the University of Medicine and Dentistry of New Jersey would be on the road to restoring its tattered reputation.
But a year of relentless revelations at the nation's largest health sciences university has changed his mind, and Christie now sees no end in sight for the monitor, former federal Judge Herbert J. Stern.
"I really now have no idea how bad this place is, and I cringe to think about what we're going to find next," Christie said. For more: http://www.nj.com/news/ledger/index.ssf?/base/news-10/116633454795930.xml&coll=1
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Health Care Company Owner Charged with Medicaid Fraud
WSLS News Channel 10 reported on December 20 that “Joseph Etienne Jr., a Richmond health care company owner is now in jail for stealing hundreds of thousands of dollars from the government as part of a Medicaid fraud scheme.” For more: http://www.wsls.com/servlet/Satellite?pagename= WSLS%2FMGArticle%2FSLS_BasicArticle&c= MGArticle&cid=1149192283551&path=!news!localnews
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TWCC subscribers notice: The next issue of This week in Corporate Compliance will be sent on January 5th, 2007.
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This week, MediRegs provided TWCC readers with the following Regulatory information: In the Federal Register, CMS Transmittals, and From the OIG.
Regulatory News
CMS Updates
NPI Compliance
Five months remain until the NPI compliance date. A recent survey of the health care industry, conducted by the Workgroup for Electronic Data Interchange (WEDI), indicates that providers should be moving from the enumeration stage into the implementation stage to ensure NPI readiness by the compliance date. Remember, it is estimated that it may take up to 120 days to complete the work needed in order to implement the NPI into your current business practices. The following steps will assist you in your preparation:
- Enumerate: Have you applied for your NPI(s)?
Not only should individual providers (Type 1) have enumerated, but organizations and subparts (Type 2) should have enumerated also.
- -Update: Have you received your software application updates, upgrades and/or changes relevant to NPI? Be sure that the updates not only addresses the HIPAA Transactions, but includes the CMS1500, UB04 and/or Dental claim form changes.
- Communicate: Have you communicated your NPI(s) to your health plans and other organizations you work with? Keep in mind, as outlined in current regulation, all covered providers must share their NPI with other providers, health plans, clearinghouses, and any entity that may need it for billing purposes -- including designation of ordering or referring physician.
- Collaborate: Do you know the readiness of your trading partners (such as health plans, TPAs, clearinghouses, etc...)? It's important to work with your trading partners to know their readiness with NPI and how it impacts you.
- Test: Have you started testing the NPI, both internally and externally? Not only do you need to test the HIPAA Transactions such as 837 Claims, but if you process 835 Remittance Advice, be sure to test that your system can process the NPI appropriately. Also, if you submit paper claims, be sure that you've tested the data being printed in the correct fields.
- Educate: Have you educated your staff on what the NPI is and the use of it? It's important that staff who may be using the NPI in day-to-day work, such as verification of eligibility, or other tasks that may need the NPI, be aware of the NPI and the provider identifiers that it replaces. The staff may have to change policies and procedures.
- Implement: Have you implemented the NPI into your business practices? Once testing is complete, changes will go into production. Prior to doing this, you'll need to make sure your trading partners are ready to process with the NPI only. Given all the steps above, will you be ready by May 23, 2007?
Enumeration Advice for Incorporated Individual Providers
Health care providers who are individuals are eligible for an Entity Type 1 (Individual) NPI. If these individuals incorporate themselves (i.e., if they form corporations) and the corporations are health care providers, the corporations are organization providers that are eligible for an Entity Type 2 (Organization) NPI. If either of these health care providers (the individual or the corporation) are covered providers (i.e. providers that send electronic transactions) under HIPAA, the NPI Final Rule requires them to obtain NPIs.
Reminder to Supply Legacy Identifiers on NPI Application
CMS continues to urge providers to include legacy identifiers on their NPI applications. This will help all health plans, including Medicare, to get ready for May 23, 2007. If reporting a Medicaid legacy number, include the associated State name. If providers have already been assigned NPIs, CMS asks them to consider going back into the NPPES and updating their information with their legacy identifiers if they did not include those identifiers when they applied for NPIs. This information is critical for health plans and health care clearinghouses in the development of crosswalks to aid in the transition to the NPI.
Common Testing Error Identified
Given recent testing experience, one common testing error found is that claims submitters check that they are submitting an NPI in the 2010AA Billing Provider REF02 segment instead of NM109. The REF segment is situational, but required if it is necessary to report a secondary ID, such as a legacy identifier and a taxpayer identification number. NM109 is where the NPI is to be submitted, but the claim submitter incorrectly submits a legacy identifier instead. Remember to make sure you correctly designate the type of identifier you are submitting to aid in crosswalk development during this testing phase.
NPI Questions
CMS continues to update our Frequently Asked Questions (FAQ's) to answer many of the NPI questions we receive on a daily basis. Visit the following link to view all NPI FAQ's:
http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/ std_alp.php?p_sid=Qjr3YRYh&p_lva=&p_li=&p_page=1&p_cv= &p_pv=&p_prods=0&p_cats=&p_hidden_prods=&prod_lvl1= 0&p_search_text=NPI&p_new_search=1&p_search_type= answers.search_nl
Providers should remember that the NPI Enumerator can only answer/address the following types of questions/issues:
- Status of an application
- Forgotten/lost NPI
- Lost NPI notification letter (i.e., for those providers enumerated via paper or web-based applications)
- Trouble accessing NPPES
- Forgotten password/User ID
- Need to request a paper application
- Need clarification on information that is to be supplied in the NPI application
Providers needing this type of assistance may contact the enumerator at 1-800-465-3203, TTY 1-800-692-2326, or email the request to the NPI Enumerator at CustomerService@NPIenumerator.com .
Please Note: The NPI Enumerator’s operation is closed on federal holidays. The federal holidays observed are: New Year's Day, Independence Day, Veteran’s Day, Christmas Day, Martin Luther King's Birthday, Washington's Birthday, Memorial Day, Labor Day, Columbus Day, and Thanksgiving
Important News for Providers: Requirement of Taxonomy Codes on Institutional Provider Claims
Effective January 1, 2007, institutional Medicare providers who submit claims for their primary facility and its subparts (such as psychiatric unit, rehabilitation unit, etc.) must report a taxonomy code on all claims submitted to their FI. Taxonomy codes shall be reported by these facilities whether or not the facility has applied for NPIs for each of their subparts. Institutional providers that do not currently bill Medicare for subparts are not required to use taxonomy codes on their claims to Medicare.
A recent MLN Matters article discusses this requirement in more detail and may be viewed at http://www.cms.hhs.gov/MLNMattersArticles/ downloads/MM5243.pdf
Reminder to Submit Claims with Your NPI and your Legacy Number
From October 1, 2006 through May 22, 2007 or until further notice, CMS recommends that Medicare providers submit claims using both the provider’s NPI and legacy number or just the provider’s legacy number.
If claims are submitted with only an NPI:
- Claims for which Medicare systems are unable to properly match the incoming NPI with a legacy number may be rejected/returned as unprocessable to the provider. The provider will then need to resubmit the claim with the appropriate legacy number.
Reminder of DME Supplier Enumeration Requirement
As mentioned in the paper entitled, “Medicare Expectations on Determination of Subparts by Medicare Organization Health Care Providers Who Are Covered Entities Under HIPAA,” Medicare DME suppliers are required to obtain an NPI for every location. The only exception to this requirement is the situation in which a Medicare DME supplier is a sole proprietor. A sole proprietor is eligible for only one NPI (the individual’s NPI) regardless of the number of locations the supplier may have.
Communicating NPIs to Medicare
Medicare providers should know that there is no “special process” or need to call to communicate NPIs to the Medicare program. NPIs can be shared with the Medicare program by using them on your claims along with your legacy identifier. Secondly, for providers applying for Medicare enrollment, an NPI must be reported on the CMS-855 enrollment application (along with a photocopy of the NPI notification received by the provider from the NPPES or from an EFIO). Existing Medicare providers must provide their NPIs when making any changes to their Medicare enrollment information
Listening Session Regarding the Medicare Hospital Value-Based Purchasing Plan
The Centers for Medicare and Medicaid Services will conduct a Listening Session on January 17, 2007 on design issues for the Medicare Hospital Value-Based Purchasing Plan. The Plan is authorized by Section 5001(b) of the Deficit Reduction Act of 2005. An Issues Paper outlining the questions to be discussed at the Listening Session will be posted no later than January 3, 2007 on the CMS website, Hospital Center, under Spotlights at: http://www.cms.hhs.gov/center/hospital.asp.
The Listening Session will be held from 10 AM to 5 PM in the CMS Baltimore auditorium. Attendees will have the opportunity to present verbal comments if they have registered in advance to do so. A dial-in number will be provided for those who cannot attend, but due to time constraints, telephone participants will not be able to make verbal comments. Written comments on the Issues Paper will be accepted until January 24, 2007.
Registration is required for both on-site and teleconference participation. Registration information is available at: http://registration.intercall.com/go/cms2. Confirmation of registration is provided.
For more information about the Listening Session, please view the Federal Register Notice (CMS-1383-N) at: http://www.cms.hhs.gov/quarterlyproviderupdates/ downloads/cms1383n.pdf .
New Training Courses Offered
New Web-based Training Course for Professional Providers
Understanding the Remittance Advice for Professional Providers Web-based training (WBT) course is now available through the Medicare Learning Network. This WBT course is designed to provide professional providers and their billing staff with general remittance advice (RA) information. This course provides instructions to help professional providers interpret the RA received from Medicare and reconcile it against submitted claims. Course participants will receive guidance on how to read Electronic Remittance Advices (ERAs) and Standard Paper Remittance Advices (SPRs). The course also provides an overview of software that Medicare provides free to providers for viewing ERAs. The course takes approximately 90 minutes to complete and participants may receive .2 CEUs for successful completion. To register to take this WBT course participants can go to the Medicare Learning Network’s Product Ordering Page located at http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident= kc0001&loc=5 and click on the course title.
Quick Reference Information: Medicare Immunization Billing Chart Available to Order
The Quick Reference Information: Medicare Immunization Billing chart is now available in hardcopy or as a download from the Medicare Learning Network. This two sided laminated chart gives Medicare fee-for-service physicians, providers, suppliers, and other health care professionals quick information to assist with filing claims for influenza, Pneumococcal Polysaccharide (PPV), and Hepatitis B (HBV) vaccines and their administration. To download, view and print the chart go to http://www.cms.hhs.gov/MLNProducts/downloads/ qr_immun_bill.pdf or a hardcopy of the chart can be ordered through the Medicare Learning Network Product Ordering Page at http://cms.meridianksi.com/kc/main/kc_frame.asp?kc_ident= kc0001&loc=5.
Hospital Outpatient Prospective Payment System Fact Sheet
The Hospital Outpatient Prospective Payment System Fact Sheet, which provides general information about the Hospital Outpatient Prospective Payment System, ambulatory payment classifications, and how payment rates are set, is now available in print format from the Medicare Learning Network (MLN). To place your order, visit www.cms.hhs.gov/mlngeninfo, scroll down to “Related Links Inside CMS,” and select “MLN Product Ordering Page.”
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In the Federal Register
Multiple Agency Rule Issued on Nondiscrimination and Wellness Programs in Health Coverage in the Group Market
The IRS, Departments of Treasury and Labor, CMS and HHS issued a final rule containing provisions prohibiting discrimination based on a health factor for group health plans and issuers of health insurance coverage offered in connection with a group health plan. The rule changes the Internal Revenue Code of 1986, ERISA, and the PHS Act (enacted as part of HIPAA).
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_fr69_cms&u=0612133&h= top1.html&t=80&s=twcc
OIG and HHS Solicit Recommendations on Safe Harbor Provisions
On December 11, 2006, OIG and HHS issued their annual notice soliciting proposals and recommendations for developing new and modifying existing safe harbor provisions under the Federal anti-kickback statute, as well as developing new OIG Special Fraud Alerts.
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_fr69_oig&u=0612112&h= top1.html&t=80&s=twcc
CMS Publishes Final Patients' Rights Rule on Use of Restraints and Seclusion
Health care workers who employ physical restraints and seclusion when treating patients must undergo new, more rigorous training to assure the appropriateness of the treatment and to protect patient rights, according to a regulation published in the Federal Register today by the Centers for Medicare & Medicaid Services (CMS)
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From the GAO
Veterans' Disability Benefits: VA Can Improve Its Procedures for Obtaining Military Service Records GAO-07-98, December 12, 2006.
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CMS Transmittals
Medicare Claims Processing (PUB. 100-04)
Transmittal #1126, Date: December 8, 2006 Announcement of Medicare Rural Health Clinics (RHC's) and Federally Qualified Health Centers (FQHC's) Payment Rate Increases (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_04&u=mrepm10004r1126cp&h=top1.html&t=80&s=twcc
Transmittal #1125, Date: December 8, 2006 Fee Schedule Update for 2007 for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_04&u=mrepm10004r1125cp&h=top1.html&t=80&s=twcc
Transmittal #1124, Date: December 8, 2006 Quarterly Update to Correct Coding Initiative (CCI) Edits, Version 13.0, Effective January 1, 2007 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_04&u=mrepm10004r1124cp&h=top1.html&t=80&s=twcc
Transmittal #1123, Date: December 8, 2006 Instructions for Downloading the Medicare Zip Code File (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_04&u=mrepm10004r1123cp&h=top1.html&t=80&s=twcc
Transmittal #1122, Date: December 8, 2006 2007 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_04&u=mrepm10004r1122cp&h=top1.html&t=80&s=twcc
Program Integrity (PUB. 100-08)
Transmittal #178, Date: December 8, 2006 Medically Unlikely Edits (MUE's) **Rescinds Transmittal #155, dated August 4, 2006**(PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mr_pm_100_08&u=mrpm10008r178pi&h=top1.html&t=80&s=twcc
CMS One-Time Special Notification (PUB. 100-20)
Transmittal #252, Date: December 8, 2006 Additional Codes for Physician Voluntary Reporting Program (PVRP)(PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_pm_100_20&u=mrepm10020r252otn&h=top1.html&t=80&s=twcc
CMS Program Manuals - Provider Reimbursement (PUB. 15)
Transmittal #431, Date: December 8, 2006 Table 18: Medicare Payment Rates for Routine SNF-type Services by Swing-bed Hospitals During calendar year 2007 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=hc_pm_pr&u=hcpmprr431pr1&h=top1.html&t=80&s=twcc
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From the OIG
Corporate Integrity Agreements
Blood and Marrow Transplant Group of Georgia, P.C. - Atlanta, GA - 10/16/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=blood&h=top1.html&t=80&s=twcc
Colman, Andrew - Bloomfield Hills, MI - 09/14/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=colman&h=top1.html&t=80&s=twcc
Danbury Hospital, Inc. - Danbury, CT - 10/23/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=danbury&h=top1.html&t=80&s=twcc
Healthsouth Corporation Addendum - Birmingham, AL - 11/02/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=healthsouthadd&h=top1.html&t=80&s=twcc
Integris Baptist Medical Center, Inc. - Oklahoma City, OK - 11/02/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=integrisbap&h=top1.html&t=80&s=twcc
Integris Health, Inc. - Oklahoma City, OK - 11/02/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=integrishlth&h=top1.html&t=80&s=twcc
Northside Hospital, Inc - Atlanta, GA - 10/16/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=nside&h=top1.html&t=80&s=twcc
Pan American Hospital Corporation, Inc. - Miami, FL - 07/14/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=panamer&h=top1.html&t=80&s=twcc
Silverstone, William Robert - Commerce, MI - 09/14/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=silverstone&h=top1.html&t=80&s=twcc
Trimas, Marvin - Farmington Hills, MI - 09/14/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=trimas&h=top1.html&t=80&s=twcc
Westland Clinic - Westland, MI - 09/14/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=westland&h=top1.html&t=80&s=twcc
Valley Crest Nursing Home (d/b/a Luzerne County) - Wilkes-Barre, PA - 4/4/2001 - CLOSED: 11/03/06 (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_cia&u=1536&h=top1.html&t=80&s=twcc
List of Excluded Individuals/Entities
OIG 11/06 Cumulative Sanction Report-Reinstatements for November 2006 (Excel):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_fed_gov_oig_csr&u=0611rein&h=top1.html&t=80&s=twcc
OIG 11/06 Cumulative Sanction Report-Update for November 2006 (Excel):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_fed_gov_oig_csr&u=0611up&h=top1.html&t=80&s=twcc
Audit Reports
Review of Corrective Actions Concerning the Human Subject Research Program (A-06-06-00042; 11/2006) (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_oig_oas_fda&u=60600042&h=top1.html&t=80&s=twcc
Review of Royalty Payments for Intramural Inventions Received by the National Institutes of Health in Fiscal Year 2004 (A-03-04-03000; 11/2006) (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_oig_oas_nih&u=30403000&h=top1.html&t=80&s=twcc
Review of Medicaid Outpatient Drug Expenditures in Nebraska for the Period October 1, 1997, Through September 30, 2004 (A-07-05-04056; 11/2006) (PDF):
http://twcc.mediregs.com/cgi-bin/_trial/efgn?c=mre_oig_oas_cms2005&u=70504056&h=top1.html&t=80&s=twcc
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This Week’s Link:
CMS Issues Guidance for Employee Education About False Claims Recovery
http://www.hcca-info.org/AM/Template.cfm?Section=Home
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Acronym Library
| BDOD | Beneficiary Date of Death |
| BDP | Beneficiary Database Prototype |
| BDPC | Breakthrough Drug Pricing Committee |
| BDPP | Beneficiary Database Prototype Project |
| BDTS | Batched Data Transmission System |
For more from CMS Acronyms: http://www.cms.hhs.gov/acronyms/listall.asp
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This Week in Corporate Compliance (781) 593-4924
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