Compliance Column: PPS Implementation Cautions: Dangerous and Deep Corporate Compliance Waters  

Oleh:

Gingerich, Barbara Stover

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Home Health Care Management & Practice vol. 13 no. 4 (Jun. 2001), page 299-300.
Topik: activity-based costing; analyses; grouper; Prospective Payment System
Fulltext: 299HHC134.pdf (35.0KB)

Isi artikel

Historically, for home care organizations, corporate compliance has meant that supply and equipment usage should be monitored for compliance with reasonable standards of use. This area of compliance risk also entails billing for medically unnecessary services. This is an area of increased emphasis in the Prospective Payment System (PPS) environment. With several of the Home Health Resource Group’s (HHRG’s) case mix assignments and reimbursements geared toward level and service utilization, that is, therapy utilization and low utilization payment, future Office of the Inspector (OIG) initiatives in the home care arena will focus on appropriate use and billing of medically necessary services.

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