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Biomedical subjects

M M Manning

Publications and source records attributed to M M Manning.

At least 19 recordsLinked to original sources
PubMed1995

The brave new world of Medicare and Medicaid fraud and abuse enforcement: whistle-blowers, pre-filing agreements, and voluntary disclosure.

Providers participating in the recent wave of mergers, acquisitions, and affiliations may have unwittingly expanded their false claims exposure because many false claim-type situations are difficult, if not impossible, to identify in pre-closing due diligence. In addition, the possibility of retrospective characterization of ordinary billing mistakes as "false claims" increasingly introduces significant uncertainty to the average provider's financial future. To date, the single most effective approach to this problem is an independent compliance review to identify and resolve any existing exposure, including voluntary disclosure if appropriate, and an ongoing compliance program to communicate to all employees not only the content of applicable rules but also the genuine commitment of management to ensure continuing compliance above other concerns.

Fraud↗
PubMed1995

Effects of alpha 2-adrenergic receptor agonist and antagonist drugs on cholinergic contraction in bovine tracheal smooth muscle in vitro.

Effects of alpha 2-adrenergic receptor stimulation on the cholinergic contractile response of bovine tracheal smooth muscle were studied. To determine the presence and function of alpha2-adrenergic receptors on cholinergic nerves innervating bovine tracheal muscle, effects of 2 alpha 2-adrenoceptor agonists and an antagonist were determined. Muscular contractions were elicited by either electrical field stimulation (EFS) or exogenous acetylcholine (ACH). The contractile response to EFS and exogenous ACH was examined for each tissue. Electrical field stimulation of bovine tracheal smooth muscle caused contractions that were completely abolished by atropine, indicating that predominant excitatory innervation of bovine trachea is cholinergic. The alpha 2 adrenoreceptor agonists clonidine and medetomidine (10(-6) M to 10 (-4) M) concentration-dependently inhibited the contractile response to EFS but not the response to exogenous ACH. Contractions induced by EFS were significantly (P < 0.05) inhibited in clonidine (10(-4) M) - treated tissues at low frequencies (0.01 to 10 Hz), whereas medetomidine (10(-5) M, 10(-4) M) inhibitory effects of the alpha 2-adrenoreceptor agonists clonidine and medetomidine were attenuated by the a2-adrenoreceptor antagonist tolazoline. The alpha 2-agonists used in this study appear to cause prejunctional inhibition of cholinergic nerves, because the smooth muscle contractions elicited by EFS, but not exogenous ACH, were inhibited, compared with controls.

Acetylcholine↗
PubMed1994

Barotrauma in a cat.

A 3.5-year-old domestic long-hair cat was admitted to the veterinary hospital for routine procedures, including dental prophylaxis. The cat appeared clinically normal. General anesthesia was induced, and 30 minutes later, the pop-off valve was inadvertently left in a closed position. The cat developed pneumothorax, which was treated via thoracentesis and administration of oxygen. The condition resolved and the cat was released from the hospital to its owner. Barotrauma resulted because of high pressure in the anesthetic circuit. Barotrauma is a life-threatening complication of general anesthesia.

Anesthesia, General↗
PubMed1994

Special report on reimbursement. Medicare and Medicaid false claims prosecutions: your clerk's mistake can subject you to criminal penalties!

A number of steps are available to individual and institutional providers to minimize exposure under the new wave of enforcement activity. The first is education: learn what rules apply in your setting and share that knowledge with management and line employees. Second, undertake an independent compliance review to identify and resolve any existing exposure, including voluntary disclosure to the authorities, if appropriate. Third, institute an ongoing program to communicate to all employees not only the content of applicable rules, but also the genuine commitment of management to ensure continuing compliance above other concerns.

Fraud↗
PubMed1993

The laparoscopic diagnosis and treatment of cavernous hemangioma hemorrhage following blunt trauma.

Cavernous hemangiomas are the most common benign tumor of the liver. A patient presented several hours after sustaining blunt trauma to the abdomen. A CT scan of the abdomen demonstrated blood in the peritoneal space and several cavernous hemangiomas of the liver. Laparoscopy confirmed the liver lesions as the source of bleeding, although there was no active blood loss. All intraabdominal blood was aspirated and the patient made an uneventful recovery without further blood loss. Laparoscopy allowed inspection of the abdomen which revealed cessation of intraabdominal hemorrhage from the cavernous hemangiomas. He made a successful recovery without further testing or operative intervention.

Abdominal Injuries↗
PubMed1992

Special report on reimbursement. Medicare program abandons 1986 malpractice rule.

Hospitals with claims "properly pending" before fiscal intermediaries or in the courts need do nothing in order to obtain corrected reimbursement for fiscal years so pending. However, to speed processing of corrected reimbursements for fiscal years pending in appeals before the PRRB, hospitals should request that the Board determine its jurisdiction and remand to the fiscal intermediary for payment as soon as possible. It will be helpful to include with any such request a copy of the notice of program reimbursement and the original appeal letter for each fiscal year under appeal. Despite the fact that HCFA Ruling 91-1 effectively concedes that HCFA has applied an invalid regulation to all fiscal years since May 1, 1986, HCFA counsel have stated that HCFA will not permit reopening of closed cost reports to correct the inappropriate apportionment of malpractice insurance costs. Nevertheless, hospitals that do not presently have a claim or appeal pending have several options. Under the Provider Reimbursement Manual, HIM-15, sections 2930-2931, fiscal intermediaries are required to reopen cost reports filed within the three-year reopening period to correct errors. Accordingly, should a fiscal intermediary deny a provider's reopening request, the provider should seriously consider taking an appeal to the PRRB. The PRRB's jurisdiction to review fiscal intermediary denials of requests to reopen cost reports was affirmed by the United States Court of Appeals for the Ninth Circuit, see State of Oregon v. Bowen, 854 F.2d 346 (9th Cir. 1988), a decision that is controlling in California, Oregon, Washington, Nevada, Arizona, Montana, Idaho, Hawaii, Alaska, Guam, and the Northern Mariana Islands.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Allocation↗
PubMed1990

Strategies for appeals of PRO payment denials.

Review of care furnished to Medicare patients by peer review organizations often results in denials of payment for services found not to be "covered" by the Medicare program. Providers should be aware that they can appeal these denials of payment, and that, at least at present, there is a good chance that such denials can be reversed on appeal.

Financial Management, Hospital↗