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Prepare for National Medicare Recovery Audit Contractors

Because Recovery Audit Contractors (RACs) are a permanent part of the Medicare program, health care providers nationwide may be audited by the Centers for Medicare & Medicaid Services (CMS). Be proactive by learning about the process and developing a strategy in case you are selected for an audit. More

Health Care Spending to Reach 49 Percent of GDP

by Joe White
In a January 2008 report, the Congressional Budget Office (CBO) reported that unless there is an unprecedented change in the long-term trend, health care spending will continue to significantly grow as a share of GDP over the coming decades. More

Health Care Organizations Under Renewed Audit Scrutiny

by Randy Romes
Hackers and organized crime groups are targeting health care executives in the hopes of gaining access to personal information. More

Are You Accurately Coding Medicare SNF RUG Claims?

Based on 2006 research that suggested Medicare had significantly overpaid skilled nursing facility (SNF) Resource Utilization Groups’ (RUGs) claims, the Centers for Medicare & Medicaid Services is focusing on coding accuracy to prevent overpayment. It is critical your medical records support the care you are delivering. More

Frequently Asked Questions About SAS 70

Does your organization provide evidence of information safeguarding controls and security practices? Many industries are now requiring vendors present this evidence by obtaining a SAS 70 audit. View answers to the commonly asked questions we’re receiving from leaders of organizations in all of the industries we serve.

Weak Collection and Bad Debt Policies Could Result in Medicare Denials

To avoid Medicare bad debt denials, health care organizations should review their bad debt policies to ensure they are abiding by the regulations outlined in the Medicare Provider Reimbursement Manual. More

Redesigned 990 Requires Extensive Preparation

Nonprofits need to begin preparing for the revised Form 990, which goes into effect for the 2008 tax year (returns due May 15, 2009 or after). Because the reporting requirements have increased substantially, many organizations will have to build accounting systems and practices to gather the information now required. More

Strengthen Your Security Strategy Prior to Onset of HIPAA Regulators

To address threats to health care data and information system vulnerabilities, the government is gearing up to conduct HIPAA security audits in 2008. How would your hospital hold up if audited or attacked by criminals? Don’t wait to find out. More

Upcoming Changes to 403(b) Plans Require Foresight—Don’t Risk Noncompliance

Organizations need to begin preparing to ensure compliance with the first major regulation changes to 403(b) plans in four decades. They generally become effective on January 1, 2009. Revisions to the Form 5500 filing requirements also go into effect at the same time—making certain 403(b) plans subject to an audit—similar to
401(k) plans. More

Reduced Payments for CAHs on Medicare Advantage Swing Bed Days

According to a clarification from the Centers for Medicare & Medicaid Services (CMS), the Medicare Advantage swing bed days should now be documented on the same line in the cost report as the skilled nursing facility (SNF) swing bed days. More

SAS 104-111: Preparing for Your Auditors Can Minimize Fee Increases

Eight new risk assessment standards (SAS 104-111) go into effect for financial statement audit periods beginning on or after December 15, 2006. The new standards widely expand and change the audit process for privately-held entities. Are you prepared for your auditors? It’s not too late to begin preparing for June year-end audits. More

Audit Committees' Responsibility for Managing Risk

Learn about the increasing risk management responsibilities of audit committees, potential consequences of ineffective risk management programs, and training for nonprofit audit and compliance committee members, boards, CEOs, and CFOs.

Court Orders Nonprofit to Pay Property Taxes—Signifying a Trend

In a majority ruling (four-to-three), the Minnesota Supreme Court (the Court) reversed a nonprofit organization’s property tax exemption. The Court’s decision stated that the nonprofit is not a “purely public charity” because it doesn’t provide goods and services free or at a significantly reduced rate. More

OIG Work Plan Reveals Targeted Risk Areas for 2008

The Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) have issued the OIG Work Plan for fiscal year 2008. Health care organizations participating in federally funded programs should dissect the plan to determine their compliance in the targeted areas for audits, evaluations, and inspections. More

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