SAMHSA Announces $69 Million in Funding Opportunities for Grant Programs
The Substance Abuse and Mental Health Services Administration (“SAMHSA”) announced $69.1 million in funding opportunities for the Children’s Mental Health Initiative (“CMHI”); Implementing Zero Suicide in Health Systems (“Zero Suicide”); and Assisted Outpatient Treatment (“AOT”). $43 million will go towards CMHI, a program that provides comprehensive community mental health services to children through young adults through age 21 with serious emotional disturbance (“SED”). $16.1 million will go towards Zero Suicide, a program that provides resources to healthcare systems that implements the Zero Suicide framework for adults who are at risk for suicide. $10 million will go towards AOT, a program that facilitates AOT for adults with serious mental illness.
HHS-OIG Report Finds Inaccurate ED Procedure Codes Used on Medicare Claims Resulting in Over $15 Million in Improper Payments
HHS-OIG issued a report that CMS did not ensure compliance with Medicare requirements for claims billed using emergency department procedure codes that resulted in over $15 million in improper or potentially improper payments. Medicare billing for emergency services is not appropriate if the site of service is other than an emergency department. The report found that service codes (for physician claims) and revenue center codes (for hospital claims) were improperly billed as a non-emergency. Medicare improperly paid physicians for 9,749 procedural codes that were improperly billed for ED procedures with non-emergency places of service codes. Medicare made about $14.2 million in potential improper payments to hospitals for claims billed with ED procedure codes and non-emergency revenue center codes.
HHS-OIG Issues Favorable Opinion Regarding Transfer of Ownership for ASC
HHS-OIG issued a favorable advisory opinion to a requestor-corporation regarding the transfer of ownership interest by the requestor’s sole shareholder in anticipation of the shareholder’s retirement from medical practice. The proposed arrangement consists of three phases. In each phase, there would be a distribution of (i) ownership interest in requestor to one or more individuals and (ii) financial distributions in the form of a return on investment to those individuals.
HHS-OIG Issues Favorable Opinion Regarding Medical Technology Manufacturer Proposal to Offer Discounts to ASCs
HHS-OIG issued a favorable opinion to a medical technology manufacturer and distributor’s proposal to offer discounts on, among other supplies, intraocular lenses used to perform cataract surgery to certain ambulatory surgical centers. The favorable opinion was contingent on the affiliated physician practices purchasing the requestor’s software product.