Obtaining critical claims data may soon get easier
By
John O'Connor
Jun 05, 2015
The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?
Obama sending mixed message on Medicare prescription prices
Apr 30, 2015
Prescription drug prices are likely to resurface as a hot political potato in the looming presidential race, beginning with the president’s recent bombshell that he wants to let Medicare bargain...
Providers suffering Medicare appeals backlog — at their own hand?
By
James M. Berklan
Apr 29, 2015
If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn’t be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise,...
Smart cards would do little to curtail Medicare fraud: GAO
By
John Hall
Apr 28, 2015
Medicare beneficiary smart cards would have a limited impact on reducing fraud and could even introduce “new, more sophisticated fraud schemes,” a new report by the Government Accountability...
RAC groups battle provider plea for short-stay payment relief
By
John Hall
Feb 19, 2015
Third-party firms that audit Medicare bills for payment issues are pushing back hard against a hospital association plea for more favorable short-stay reimbursements, adding to the ongoing unwelcome specter...
White House budget could include surprises Monday
Jan 29, 2015
Long-term care providers will be among the Americans especially interested Monday to learn what President Obama will include in his 2016 budget proposal.
The Jimmo scorecard and CMS compliance update
By
Steven Littlehale
Nov 25, 2014
In some ways, 2014 has been a monumental year. But it’s not over yet, especially with regard to Centers for Medicare & Medicaid Services steps regarding the historic Jimmo settlement agreement signed...
Federal court dismisses whistleblower lawsuit over Omnicare, PharMerica withholding generic drugs
By
Tim Mullaney
Aug 18, 2014
A federal court in New York has tossed a whistleblower lawsuit charging that large long-term care pharmacies violated the False Claims Act by failing to dispense requested generic drugs.
Same-sex married couples now have expanded Medicare enrollment options, HHS announces
By
Tim Mullaney
Apr 04, 2014
Seniors now are eligible to receive premium-free Medicare Part A coverage if they are married to someone of the same sex, the Department of Health and Human Services announced Thursday.
Medicaid-only long-term care residents driving up state expenditures, report finds
By
Tim Mullaney
Feb 20, 2014
Among people eligible for Medicaid but not Medicare, long-term care residents are most likely to be among the costliest beneficiaries for a state, according to a new report from the Government Accountability...