OIG: Medicare contractors overpaid for radiation therapies

Medicare contractors may have significantly overpaid for intensity-modulated radiation therapy services, according to a new report from the U.S. Dept. of Health and Human Services’ Office of the Inspector General. In its report, the OIG said that it reviewed claims paid to hospitals from National Government Services, Inc., that contained specific IMRT services at risk for noncompliance with Medicare requirements. The office identified 25,9000 claims paid by NGS that contained “potentially unallowable IMRT services totaling $80.1 million.” The federal watchdog estimates that Centers for Medicare and Medicaid Services overpaid “at least $5.7 million for unallowable IMRT services” in MAC jurisdictions 6 and K based on data from the audit of NGS. The OIG added that it also sampled 100 random beneficiaries and submitted their associated services for independent medical review, and found that NGS maid overpayments for at least 1 service for 99 of the 100 beneficiaries. Overpayments occurred due to system edits not preventing NGS payments to hospitals for incorrectly billed IMRT services and because hospitals were “unfamiliar with or misinterpreted Medicare guidance when billing for IMRT services, or cited clerical errors,” the OIG reports. The OIG said it made three recommendations to NGS for recovering the overpayments it identified, and two procedural recommendations for payment edits and hospital education on IMRT billing. Earlier this m...
Source: Mass Device - Category: Medical Devices Authors: Tags: Business/Financial News Featured Dept. of Health & Human Services (HHS) Source Type: news

Related Links:

The objective of this study was to investigate the effect of field output factors (FOFs) according to the current protocol for small-field dosimetry in conjunction to treatment planning system (TPS) commissioning. The calculated monitor unit (MU) for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans in Eclipse™ TPS were observed. Micro ion chamber (0.01 CC) (CC01), photon field diode (shielded diode) (PFD), and electron field diode (unshielded diode) (EFD) were used to measure percentage depth doses, beam profiles, and FOFs from 1 × 1 cm2 to 10 &t...
Source: Journal of Applied Clinical Medical Physics - Category: Physics Authors: Tags: J Appl Clin Med Phys Source Type: research
and L Abstract OBJECTIVE: Our study aimed to compare regional node coverage and doses to the organ at risk (OAR) using conventional technique (CT) vs "AMAROS" (AT) vs intensity-modulated radiation therapy (IMRT) techniques in patients receiving regional nodal irradiation (RNI) for breast cancer (BC). METHODS: We included 30 consecutive patients with BC who received RNI including axillary nodes. Two independent and blinded dosimetric RNI plans were generated for all patients. For target volume coverage, we analyzed the V95%, the D95%, the mean and the minimal dose within the nodal station. For hotspo...
Source: The British Journal of Radiology - Category: Radiology Authors: Tags: Br J Radiol Source Type: research
Abstract We propose a multi-view data analysis approach using radiomics and dosiomics (R&D) texture features for predicting acute-phase weight loss (WL) in lung cancer radiotherapy. Baseline weight of 388 patients who underwent intensity modulated radiation therapy (IMRT) was measured between 1 month prior to and 1 week after the start of IMRT. Weight change between 1 week and 2 months after the commencement of IMRT was analyzed, and dichotomized at 5% WL. Each Patient had a planning CT and contours of gross tumor volume (GTV) and esophagus (ESO). A total of 355 features including clinical parameter (CP), GTV and ...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research
Objective: To study the dosimetric effect on special reconstruction images obtained from an electrocardiograph-gated four-dimensional computed tomography (ECG 4D-CT) series and compare it with the accumulation dose assessment of ECG 4D-CT.Methods: Fifteen patients underwent ECG 4D-CT scans to obtain a 4D-CT series. The 20 phase images of 0–95% were reconstructed at intervals of 5% of the cardiac cycle by the 4D-CT series. The 4D-CT series was specially reconstructed, and the maximum intensity projection (MIP), minimum intensity projection (MinIP), average intensity projection (AIP), and sum intensity projection (SIP)...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
We report our experience in developing and refining CSI planning and treatment parameters, using a 3-isocenter image-guided intensity-modulated radiation therapy (IG-IMRT) technique.
Source: Journal of Medical Imaging and Radiation Sciences - Category: Radiology Authors: Tags: Research Article Source Type: research
CONCLUSION: Once weekly low dose cisplatin treatment showed lower acute toxicity and a better compliance compared to once every 3 weeks high dose cisplatin treatment at the expense of a lower loco-regional control. PMID: 32212810 [PubMed - in process]
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
Conclusion: In patients with early-stage nasal NKTCL, our LVD-IMRT regimen produced excellent, durable therapeutic benefit in most patients, with acceptable toxicity and no acute mortality.
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Original Articles: Head and Neck Source Type: research
Abstract The quality of radiation therapy has been shown to significantly influence the outcomes for head and neck squamous cell carcinoma (HNSCC) patients. The results of dosimetric studies suggest that intensity-modulated proton therapy (IMPT) could be of added value for HNSCC by being more effective than intensity-modulated (photon) radiation therapy (IMRT) for reducing side effects of radiation therapy. However, the physical properties of protons make IMPT more sensitive than photons to planning uncertainties. This could potentially have a negative effect on the quality of IMPT planning and delivery. For this ...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
ConclusionsAdaptive two-step IMRT for NPC demonstrated an excellent 3-year OS with acceptable toxicities. This method may be one treatment option for locally advanced NPC.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: SMART provided promising oncologic outcomes at the cost of significant treatment related morbidity. Due to the significant treatment associated morbidity and favorable treatment alternatives, we have not broadly adopted SMART at our institution.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
More News: Centers for Medicare and Medicaid Services (CMS) | Education | Government | Hospitals | Intensity-Modulated Radiation Therapy | Medicaid | Medical Billing | Medical Devices | Medicare | Radiation Therapy | Universities & Medical Training