Claims Processing Details Released for AUC Mandate – a Call to Action (continued…)!

By Nathan Baugh
Last month, the Centers for Medicare & Medicaid Services (CMS) released a Medicare Learning Network Article (MLN Matters) detailing certain claims processing aspects of the Appropriate Use Criteria (AUC) Mandate.

On February 20, 2020, CMS revised the MLN Matters article (SE20002) to include a list of additional Qualified Clinical Decision Support Mechanisms (qCDSMs) and their corresponding G-codes which will become effective on 4/1/20.

New Developments in Medicare Enforcement Actions: Impact of Allina

By Adrienne Dresevic, Esq. and Jessica L. Gustafson, Esq. of The Health Law Partners, P.C.
Medicare enforcement includes multiple actions, which may range from overpayment demands to enforcement of False Claims Act violations. Such actions oftentimes are predicated not only on a health care provider’s compliance with laws and regulations, but also on its compliance with sub-regulatory guidance.