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New OIG Advisory Opinion Allows No Bills for Municipal Residents, But Bills for Non-Residents

On July 9, 2013 the OIG posted Advisory Opinion 13-08, concerning a Fire Protection District ("District") policy of only billing individuals that reside outside the fire protection district for emergency medical services. Here, the District does not bill any residents or their insurers (including federal health care programs) for emergency medical services. But it does bill all...

OIG Issues Updated Special Advisory Bulletin on Excluded Individuals

Background
 
On May 8, 2013, the Office of the Inspector (OIG) issued an updated “Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs.”  Ambulance providers enrolled in Federal healthcare programs may not employ or contract with any party who is excluded from...

OIG Report on Claims with G Modifiers

On May 3, 2013 the OIG issued: Medicare Payments for Part B Claims with G Modifiers, assessing how Medicare contractors are processing G modifiers.  The OIG analyzed all Part B claims with GA, GZ, GX, or GY modifiers from 2011 and found that there were “vulnerabilities in how Medicare pays for these claims” resulting in improper payments of claims submitted with G...

HHS Publishes Final HIPAA II Regulations

On January 25, 2013, the U.S. Department of Health and Human Services (HHS) published a Final Rule implementing sweeping changes to the Health Insurance Portability and Accountability Act (HIPAA). This “Omnibus” Rule combines four different rulemakings and makes final a number of long-awaited proposed changes to the HIPAA regulations.  The bulk of the changes concerning the ambulance industry center around regulations proposed under the Health Information Technology for Economic and...

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