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The Basis for Hospital Reimbursement and Sepsis Reimbursement
By Eric Bricker MD
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Filed under: "Doctors Only", Ethics, Experts Invited, Health Economics, Health Insurance, Healthcare Finance, Videos | Tagged: charge capture, Eric Bricker MD, healthcare costs, hospital reimbursement, medical coding, MS-DRG, sepsis |
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Medicare Claws Back Money for Amniotic Stem Cell Shots
Medicare is clawing back money it paid doctors for dubious birth tissue injections — a move that likely could put some clinics out of business, an orthopedic surgeon told MedPage Today. In late February, seven U.S. regional Medicare Administrative Contractors (MACs) announced that they will seek to recover losses from claims going back more than 2 years, for shots that cost some $2,000 apiece. For clinics that injected patients in multiple joints with at least two doses per joint, that could total thousands of dollars per day.
“Any claims processed and paid for dates of service on or after Dec. 6, 2019 will be adjusted and payment will be recouped,” stated the announcement from WPS Government Health Administrators, which covers the Midwest region. “Impacted providers will receive an overpayment demand letter identifying the amount of overpayment.” The notice applies to amniotic, placental, and umbilical cord injectables, which the WPS notice describes as “experimental exosome biologic products that have not proven to be safe and effective for any medical use.”
Source: Ann Miller RN MHA via Kristina Fiore, Medpage Today [3/16/22]
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