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What is a SMRC Audit and What Should You Do?

The Centers for Medicare and Medicaid (CMS) has established multiple levels of subcontractors to identify and minimize evidence of improper payments. Each provider has a Medicare Administrative Contractor (MAC). Currently the MACs include: is Noridian Healthcare Solutions, LLC (Noridian), CGS Administrators, LLC (CGS), National Government Services, Inc. (NGS), Novitas Solutions, Inc. (Novitas), Palmetto GBA, LLC (Palmetto), and First Coast Service Options, Inc. (First Coast). View coverage by state. In addition to the contractor assigned to your organization, CMS has…

Why Do IRFs Still Need to Know About 1135 Waivers?

Our world has continued to change since March 2020 when the COVID-19 pandemic and the Public Health Emergency (PHE) were implemented. Many of the rules and regulations outlined by the Centers for Medicare & Medicaid Services (CMS) are continuing to be altered, due to the continuation of the PHE. The Medicare Benefit Policy Manual (MBPM), Chapter 1 houses the regulations that have traditionally governed Inpatient Rehabilitation Facilities (IRFs). On March 13, 2020, CMS issued blanket…

MDS Accuracy: Missed Opportunities and Mishaps and Section I – The Most Common Mistakes

In this Minimum Data Set (MDS) Accuracy Blog, we will highlight Sections and items in the MDS to review key misses that the experts at LW Consulting, Inc. (LWCI) have encountered. At LWCI, we thrive in partnering with clients to complete audits or provide consultative services to support concerns. As the experts at LWCI conduct audits, we identify commonalities with coding. Throughout this blog series we will be sharing information on optimal MDS coding, based…