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LIST OF MODIFIERS

Modifier - as the name implies a modifier will modify a service / procedure or an item under certain circumstances for appropriate reimbur...

The nine sections that detects prevention of fraud, waste, and abuse


The nine sections which gives the secretary of HHS substantial additional authority in the detection and prevention of fraud, waste, and abuse are:

• provisions to enhance existing Medicare and Medicaid program integrity provisions

• reporting requirements for the HHS Office of Inspector General (OIG)

• medical identification (ID) theft information sharing; expanded permissive exclusion provisions

• provisions to make Medicare claims data relative to providers public

• restrictions on Medicaid participation for entities with certain ownership

• control and management affiliations

• restrictions on payments for illegal unapproved drugs

• a requirement for participating individuals or entities with federal health care programs to comply with certain congressional information requests 

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