RESOURCES AND CITATIONS OIG COMPLIANCE GUIDANCE HTTPOIGHHSGOVFRAUDCOMPLIANCEGUIDANCEHTML HTTPOIGHHSGOVFRAUDCOMPLIANCEGUIDANCEHTML2 OIG

STATE OF CALIFORNIA C THE RESOURCES AGENCY PRIMARY
3 DRAFT RESOURCES FOR WORKING
ALZHEIMER’SDEMENTIA RESOURCES FOR FAMILIES THERE ARE MANY

HUMAN RESOURCES DIVISION DISCIPLINARY HEARING RECORD
HUMAN RESOURCES POLICY STATEMENT HRPS9 STAFF STUDYING
HUMAN RESOURCES RECORDS STAFFING RECORDS INVOLVING STAFF POSITIONS

RESOURCES AND CITATIONS

RESOURCES AND CITATIONS


OIG Compliance Guidance: http://oig.hhs.gov/fraud/complianceguidance.html

http://oig.hhs.gov/fraud/complianceguidance.html#2


OIG Exclusions: http://oig.hhs.gov/fraud/exclusions.html


Federal Register:

http://www.gpoaccess.gov/fr/index.html


Code of Federal Regulations:

http://www.gpoaccess.gov/cfr/index.html


Federal Sentencing Guidelines:

http://www.ussc.gov/guidelin.htm


OIG Fraud Alerts: http://oig.hhs.gov/fraud/fraudalerts.html


OIG Workplan(s): http://oig.hhs.gov/publications/workplan.html


OIG Safe Harbors: http://oig.hhs.gov/fraud/safeharborregulations.html


OIG Advisory Opinions: http://oig.hhs.gov/fraud/advisoryopinions.html


CMS E&M Documentation Guidelines: http://www.cms.hhs.gov/MLNEdWebGuide/25_EMDOC.asp


Comprehensive Error Rate Testing (CERT):

http:www.cms.hhs.gov/CERT

http:www.cms.hhs.gov/CERT/CR/list.asp

http:www.cms.hhs.gov/MLNProducts/downloads/certfactssheetv1-3.pdf


HIPAA:

http://www.cms.hhs.gov/HIPAAGenInfo/


CMS INTERNET ONLY MANUALS (IOM)

http://www.cms.hhs.gov/Manuals/IOM/list.asp


CMS Reciprocal Billing & Locum Tenen Rules: Internet Only Manuals (IOM), CMS Pub 100-04, Chapter 12, §30.2.10-30.2.11. Paper Manual: Claims Processing Manual §30.60


Shared Visits:

Internet Only Manuals (IOM), CMS Pub 100-04, Chapter 12, §30.6.1. Paper Manual: Pub 14, MCM Part 3, §15501, Transmittal 1832.


IDTF Regulations:

42CFR 410.33


Teaching Physicians:

Internet Only Manuals (IOM), CMS Pub 100-04, Chapter 12, §100.1.8


Consultations:

Internet Only Manuals (IOM), CMS Pub 100-04, Chapter 12, §30.6.1


“Incident to”:

Internet Only Manuals (IOM), CMS Pub 100-02, Chapter 15, §60.1-60.3


CLIA:

http://www.cms.hhs.gov/CLIA/


Medicaid state fraud statutes:

http://www.cms.hhs.gov/FraudStateStatutes


Medicare national physician fee schedule look-up:

http://www.PFTlookup/

**Includes payment policy indicators

RVU

Modifiers

GPCI


NCCI:

http://www.cms.hhs.gov/NationalCorrectCodiNitEd/01­_overview.asp

**Includes Manual

Code pairs, including effective dates

Modifier 59 instructions


Medicaid Fraud:

http://www.cms.hhs.gov/DeficitReductionAct/02_ CMIP.asp_ TopOfPage

National and Local Coverage determinations database (NDC and LCD)

http://www.cms.hhs.gov/CoverageGenInfo/01_ overview.asp


http://www.cms.hhs.gov/MCD/search.asp


Educational Publications and web based training:

http://www.cms.hhs.gov/MLNEdWebGuide


http://www.cms.hhs.gov/MLNMattersArticles/


Health provider and specialty shortage bonus (HPSA and PSA):

http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/Downloads/instructions.pdf


CMS Forms:

http://www.cms.hhs.gov/CMSForms/list.asp#TopOfPage


Quarterly Provider Updates:

http://www.cms.hhs.gov/QuarterlyProviderUpdates/


Physician Quality Reporting Initiative (PQRI):

http://www.cms.hhs.gov/pqri/


Healthcare provider and specialty shortage areas:

http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/Downloads/instructions.pdf


http://www.cms.hhs.gov/HPSAPSAPhysicianBonuses/Downloads/Carrier_Web_Sites.pdf


Medicare CPT statistics, including E&M by specialty:

http://www.cms.hhs.gov/MedicareFeeforSvcPartsAB/04_MedicareUtilizationforPartB.asp#TopOfPage


CMS transmittals database:

http://www.cms.hhs.gov/transmittals


Enrollment:

http//www.cms.hhs.gov/MedicareProviderSupEnroll/


NPI:

http:www.cms.hhs.gov/NationalProvIdentStand/





RESOURCES TO HELP EVALUATE COMPLIANCE OFFICER KNOWLEDGE AND EXPERTISE


HCCA sample test: http://www.hcca-info.org/AM/Template.cfm?Section=Home

From the home page, choose HCCB Certification and then select practice exam


CMS webbased training modules (multiple tested topics): http://www.cms.hhs.gov/MLNEdWebGuide/





















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JOB DESCRIPTION DEPARTMENT RESOURCES JOB TITLE FINANCE
PRACTICE NOTE SOURCING SUPPLEMENTARY EMERGENCY RESPONSE RESOURCES
((T))JOB DESCRIPTION AND RELATED POST DETAILS DEPT CORPORATE RESOURCES


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