HealthLeaders Media Finance - September 13, 2010 | 3 RAC Audit Survival Tips View as a Webpage | Subscribe for Free
3 RAC Audit Survival Tips
Jeff Elliott, for HealthLeaders Media

Nearly 70 percent of a Recovery Audit Contractors audit results are overturned through the right appeals process. Organizations that are most successful in appealing denials are the ones that take Medicare guidelines for admissions and respond to them point-by-point. [Read More]
  September 13, 2010

Editor's Picks
Medical Groups: Litigation Expenses to Cost Taxpayers $1 Billion
A reversal of federal policy that lets trial lawyers use litigation expenses as tax deductions would result in more frivolous lawsuits, add to America's healthcare bill and result in lawyers' conflict of interest, says a coalition of 90 medical groups including the American Medical Association. The groups say that it would pose a conflict with long-standing state ethics rules against trial attorneys providing financial assistance to clients. The Treasury Department is considering reversing its policy that court and other litigation expenses advanced by trial attorneys are not deductible as business expenses. [Read More]
Hospital Job Growth Up in August
The nation's hospitals reported 8,600 payroll additions in August, the largest single month of job growth for the sector in 2010 preliminary data released today by the Bureau of Labor Statistics show. The hospital sector shed 1,400 jobs in July, added 5,700 jobs in June, and shed 1,400 jobs in May, after creating 7,800 jobs in the first four months of the year. Job growth in the healthcare sector continues to be powered by ambulatory services, which accounted for 16,900 payroll additions in August, and 99,400 payroll additions in the first eight months of 2010. [Read More]
OIG: Medicare Contractor Overpaid $39.2 Million for Diabetics' Supplies
Medicare inappropriately paid $39.2 million for test strips and lancets for diabetic beneficiaries in 2007 because its administrative contractor serving 12 northeastern states failed to require proper authorization, the Office of Inspector General said last week. The scope was limited to a sample of claims that are considered "high utilization" in that they exceeded normal utilization of 100 test strips and 100 lancets each month for insulin-dependent beneficiaries and every three months for non-insulin dependent beneficiaries. [Read More]
How Patient-centered Surgery Boosts Hospitals' Bottom Line
Surgical services are a leading source of revenue for many hospitals. The OR increasingly acts as a financial engine for the organization, and more complex surgeries and greater volume typically add up to a better bottom line. As one of the most expensive and frightening stages in the care continuum, surgery has the most to gain from a more patient-centric approach. [Read More]
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If you want even better insight into what your peers are doing as healthcare experiences seismic changes, this is an opportunity you can't afford to pass up. The HealthLeaders Media Council is comprised of the nation's leading healthcare executives who collectively provide the most unbiased industry intelligence available. As a HealthLeaders reader, we invite you to qualify to become a member by completing a brief survey.
Join fellow Council members to:
  • Share your knowledge of the industry by contributing to brief online surveys
  • Access survey results and research reports in advance
  • Pose questions to solicit colleagues' opinions on your organization's most pressing challenges
  • Receive quarterly HealthLeaders Media Webcasts ($1,500 annual value) as a thank you for your participation on the Council
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Finance Forum
Medicare Fraud and Abuse Provisions Under the PPACA
President Obama recently signed off on legislation that very likely will result in a substantial increase in lawsuits against health care providers. Intended to combat fraud in the Medicare & Medicaid programs, several amendments in the Patient Protection and Affordable Care Act significantly change the status quo, and will require greater vigilance by healthcare providers in their dealings with the federal government.

[Read More]
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Finance Headlines
CA Hospitals, health centers planning new facilities, expansions
HealthLeaders Media, September 7, 2010
Healthcare Wastefulness Is Detailed in Studies
The New York Times, September 7, 2010
California regulators seek up to $9.9 billion in fines from PacifiCare
Los Angeles Times, September 8, 2010
Q-C hospitals step up mergers and acquisitions
Quad-City Times, September 8, 2010
Community hospitals scramble to survive, stay independent
USA Today, September 9, 2010
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Creating Stroke Systems of Care
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Money Talk

A look at one hospital's struggles to improve

Mayo Clinic, Rochester, MN
Rating: AA-
Outlook: Positive
Affected Debt: $1.7 billion
Agency: Standard & Poor's Ratings Services
Remarks: S&P revised its rating outlook to positive from stable and affirmed its AA- rating on various issuers' debt issued for Mayo Clinic. At the same time, S&P affirmed its various other ratings on numerous bonds issued on behalf of Mayo Clinic. Offsetting credit factors include liquidity levels that are still below similarly rated organizations. S&P also considers Mayo Clinic's asset allocation aggressive, with approximately 50% of Mayo's long-term fund in alternative assets. S&P also cites its potential exposure to future Medicare and Medicare physician reimbursement reductions.
[Read More]
Audio Feature

Create Extra Capacity, Without Extra Expense: Wayne Keathley, president of New York's Mt. Sinai Medical Center, discusses adding 10,000 patient discharges per year by working on accountability and efficiency in patient throughput. [Listen Now]
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