The government often hires “overzealous” investigators to detect fraudulent Medicare and Medicaid billing practices, a new report alleges. These examiners often target technical errors instead...
Inspector General blasts agency for ignoring ZPIC scrutiny
By
John Hall
Mar 19, 2015
Ignoring a four-year-old warning to more thoroughly evaluate Medicare auditing contractors is among the pile of unheeded advice that could have saved the Medicare program billions of dollars in recent...
Congressional lawmakers grill top ALJ on appeals backlog, say too many providers are being put out of...
By
Tim Mullaney
Jul 11, 2014
Efforts to root out Medicare fraud have put far too many above-board providers in auditors’ crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and...
Feds ease auditing reviews, anti-fraud efforts to surge
By
John O'Connor
Dec 01, 2013
Providers likely will embrace House legislation that eases billing reviews for operators deemed a low fraud risk.
BREAKING: HHS reveals provider incentive plan for remaining $2 billion in relief funding
By
James M. Berklan
Sep 03, 2020
The Department of Health and Human Services announced it will use infection and mortality rates to determine nursing home incentive pay when distributing a previously announced $2 billion Provider Relief...
Government saved $17.6 billion in 2011 due to fraud prevention programs
Nov 16, 2011
A government crackdown on improper payments in federal programs, such as Medicare and Medicaid, cut wasteful payments by $17.6 billion in 2011, the Office of Management and Budget reported Tuesday. The...
Providers face urgent review of preview reports, 6 new measures for Nursing Home Compare
By
Danielle Brown
Aug 20, 2020
Skilled nursing providers have just 10 days to review new performance data headed for the Nursing Home Compare Website. Six new measures will be on display.
Don’t consolidate quality groups to regionals: AHCA
By
James M. Berklan
Sep 01, 2013
The Centers for Medicare & Medicaid Services should not waver from its long-standing support of state-based quality improvement organizations, the American Health Care Association and nearly 50 other organizations...
CMS now offering cognitive, mood assessment training for SNF providers
By
Alicia Lasek
May 10, 2021
The training includes four virtual, on-demand courses that give providers an overview of key clinical considerations for performing these assessments in the nursing home setting, the agency announced.
CMS is two weeks late issuing report on fraud prevention efforts
By
McKnight's Staff
Oct 17, 2012
Two Republican Senators want to know why the Centers for Medicare & Medicaid Services is two weeks overdue in issuing a report on the agency’s fraud prevention system (FPS).