On October 1, 2013, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To accommodate the ICD-10 code structure, the transaction standards used for electronic health care claims, Version 4010/4010A, must be upgraded to Version 5010 by January 1, 2012.... Keep Reading

Effective January 1, 2012 the federal government has mandated that all covered entities (including providers, clearinghouses and health plans) must transition to the latest version of the Health Insurance Portability and Accountability Act (HIPAA) electronic transaction standards and code sets. The new version of the electronic transaction standards is known... Keep Reading

NEWARK N.J.—Home health-care provider Maxim Healthcare Services Co. has agreed to pay $150 million as part of a settlement with federal and state authorities to resolve criminal and civil allegations that it falsely billed government health-care benefits programs. The privately held, Columbia, Md., health-care provider reached the deal to resolve... Keep Reading

WASHINGTON – A Miami-area medical doctor who owned two medical offices pleaded guilty today for his participation in a $25 million home health Medicare fraud scheme, announced the Department of Justice, FBI and the Department of Health and Human Services (HHS). Jose Nunez, 63, pleaded guilty before U.S. District Judge Joan... Keep Reading

Center for Medicare and Medicaid Services (CMS) is requiring that all providers and suppliers enrolled with Medicare prior to March 25, 2011, must revalidate their enrollment information. Basically, all providers (home health agencies included) that bill Medicare for services provided must enroll by March 23, 2013. Section 6401 (a) of the... Keep Reading