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Executive Summary Today’s healthcare environment is rapidly changing. Hospitals and healthcare systems are being bombarded by myriad challenges, including the fluctuating economy, cuts in Medicare reimbursements, and new procedural, financial, and reporting requirements of the Affordable Care Act (ACA). All of these factors are pressuring healthcare organizations to reduce costs and improve patient outcomes without sacrificing the quality of care.
An overview of the Centers for Medicare & Medicaid Services' three final rules for calendar year 2011 the outpatient prospective payment system and ambulatory surgical center rule, the Medicare Physician Fee Schedule rule and the Home Health PPS rule.
This Special Fraud Alert focuses on the specific attributes and practices of PODs that OIG believes produce substantial fraud and abuse risk and pose dangers to patient safety.