Dual-eligible ACO model could be jeopardized by changes to Medicaid
By
Dec 21, 2016
The Centers for Medicare & Medicaid Services’ recently announced accountable care organization model for dual eligibles could be at risk if lawmakers overhaul the Medicaid program in the coming years.
United Healthcare concealed enrollment fraud complaints, lawsuit claims
By
Jul 31, 2017
UnitedHealthcare has found itself on the receiving end of another lawsuit, this time alleging the insurance giant of concealing complaints of enrollment fraud and other issues.
Price: ACA repeal bill a ‘first step’ to put Medicaid program on ‘sustainable path’
By
Mar 09, 2017
Legislation introduced this week to replace the Affordable Care Act will make the Medicaid program more sustainable, according to Department of Health and Human Services Secretary Tom Price, M.D.
CMS should look at contractor performance, government agency says
By
Jun 02, 2015
Following years of provider disputes, the Government Accountability Office released a report Monday encouraging the Centers for Medicare & Medicaid Services to look at ways to improve the Medicare Administrative...
LA could receive $15 million to improve nursing home inspections
By
Jun 30, 2015
A proposed contract between California and the Los Angeles County Department of Public Health could result in $15 million in additional funding to improve oversight and delays in nursing home investigations.
Nurses aren’t documenting all ulcer interventions: study
By
May 04, 2016
Documentation of pressure ulcer prevention measures by nursing home staff may be lacking, and not match the actual preventative measures taken, a new study suggests.
Provider consolidation may increase costs, cut quality, researchers tell lawmakers
By
Apr 17, 2017
Rising consolidation among healthcare providers, systems and insurers may be causing healthcare costs to rise while care quality suffers, according to a report published last week.
Republican lawmakers accuse CMS of focusing on recovering, not preventing, improper payments
By
Sep 13, 2016
The Centers for Medicare & Medicaid Services relies too much on investigating improper Medicare payments after they’re made instead of preventing them to begin with, Republican lawmakers said Monday.
Body wipes found shoved inside resident; ‘frustrated’ CNA arrested
By
Sep 15, 2017
A nursing assistant at an Oklahoma nursing home has been arrested after confessing to stuffing care wipes inside a resident out of frustration, according to local reports.
Medicare Advantage beneficiaries less likely to use post-acute care, analysis finds
By
May 11, 2017
More Medicare Advantage beneficiaries are being discharged from the hospital directly to their homes, instead of to a post-acute care facility, than traditional fee-for-service patients, according to a...