Darren Carter, MD has written extensively on the topic of Medicare medical necessity and other areas of regulatory compliance. This bibliography contains a listing of his books, articles, and reports. News stories that contain interviews or references to his work are listed below, too.

Books

• Medicare Medical Necessity: a Guide to Accurate Reimbursement and Full Compliance, HCPro, October 2002, (http://www.hcmarketplace.com/prod.cfm?id=1314).

Original, peer-reviewed journals

• Carter D, “Medicare cost controls and program compliance: a brief history of physician payments,” Journal of Health Practice Management, Nov/Dec 2002, 18(3): 115-119.


• Carter D, “Optimizing Revenue by Reducing Medical Necessity Claims Denials,” Healthcare Financial Management Magazine, October 2002, pp 88-92.


• Carter D, “Medical Necessity Under OPPS: A Look at the Challenges,” Journal of AHIMA, February 2002, 73(2): 44, 46-47, 51.


• Carter D, “Poor CMS Contractor Performance Could Pose Risk to Providers”, Patient Accounts, Healthcare Financial Management Association, October 2001, pp. 2-3.

Reviews, chapters, and editorials

• Carter D, “Working with Physicians on Medicare Medical Necessity”, Health Care Billing & Collection: Forms, Checklists, and Guidelines Manual, 6th annual supplement, Aspen Publishers, 2002.


• Carter D, “Complying with Medicare Medical Necessity”, Health Care Billing & Collection: Forms, Checklists, and Guidelines Manual, 5th annual supplement, Aspen Publishers, October 2001, pp 4:23.27-29.


• Carter D, “Guest Editorial: HCFA Opens the Local Medical Review Policy Process,” Orthopedic Technology Review, July/August, 2001, 4(3):6. Reprint available at http://www.orthopedictechreview.com/issues/julaug01/editorial.htm

Reports and newsletters

• Carter D, “Implementing the new ABN at your hospital”, New Jersey Hospital Association Newslink, March 2003.
  
• Carter D, “The State of Medicare Medical Necessity Compliance,” Part A Insider, December 6 and December 20, 2002, 2(19-20).


• Carter D, “CMS cost-control autopilot: Medicare prospective claims edits,” Part A Insider, submitted September 2001.


• Carter D, “OIG: Millions paid in duplicate Medicare claims,” Briefings on Coding Compliance Strategies, Opus Communications, Oct 2001, 4(10): 3.


• Carter D, “New Medicare Web pages help educate, inform,” Briefings on Coding Compliance Strategies, Opus Communications, Aug 2001, 4(8): 1, 4-6.


• Carter D, “HCFA Opens the Local Medical Review Policy Process: Mandates Posting of Drafts on the Web,” IHealthcareWeekly.com, April 11, 2001. Reprint available at http://www.ihealthcareweekly.com/issues/ihcw04112001.html#Headline1119
  
• Carter D, “What’s happening with ICD-10-CM?” Briefings on Coding Compliance Strategies, Opus Communications, July 2001, 4(6): 6-7.


• Carter D, “Chargemaster maintenance essential for Medicare compliance,” Briefings on Coding Compliance Strategies, Opus Communications, June 2001, 4(6): 3.


• Carter D, “Local Medicare Coverage: How it works”, The Receivables Report, May 2001, 16(5): 3.

News stories and interviews

• “Managing and Disposing of PHI,” Part A Insider, February 2003, 3(32): 2-4.


• “Evaluate your Medical Necessity Situation,” Briefings on Coding Compliance Strategies, Opus Communications, December 2002, 5(12):9.


• “Managing Medical Necessity: Changing Rules, New ABNs Require Refresher,“ Briefings on Coding Compliance Strategies, Opus Communications, November 2002, 5(11): 1-4.


• Transactions and code sets: Get plans and documentation in writing,” HIPAA Compliance Alert, November 2001, 1(10): 4.


• Easley B, “OIG Semiannual Report: Fraud down, but not enough”, Opus Communications: Briefings on Coding Compliance Strategies, 4(7):1, 5. Reprint available at eSurg.com, http://www.esurg.com/app/news/Story?CategoryID=35&ContentID=548


• Phalen, Kathleen, “Opting out: Physicians exiting Medicare program”, American Medical News, June 25, 2001. Reprint available at

http://www.ama-assn.org/sci-pubs/amnews/pick_01/gvsa0625.htm

• “Local medical review policies bring Medicare denials,” The Receivables Report, May 2001, 16(5):1-4.