CMS leverages technology in move from ‘pay-and-chase’ to fraud prevention
By
McKnight's Staff
Feb 26, 2013
The Centers for Medicare & Medicaid Services will utilize computer technology to shift from detecting and then prosecuting fraud (“pay-and-chase”) to preventing it, according to a CMS official...
OIG investigation raises conflict of interest concerns in ZPIC program
By
McKnight's Staff
Jul 11, 2012
Regulators need to be more aggressive in identifying conflicts of interest among Medicare’s fraud-fighting Zone Program Integrity Contractors (ZPICs), a new government report recommends.
Senators demand more data on Medicare fraud prevention efforts
By
McKnight's Staff
Aug 01, 2012
A multimillion dollar Medicare fraud-fighting command center unveiled by the federal government a week ago is already drawing fire from two Republican lawmakers.
CMS angling to ease providers’ burdens from Medicare Administrative Contractors
By
McKnight's Staff
Jan 10, 2013
The Centers for Medicare & Medicaid Services is asking providers to help figure out a way to make demands from Medicare Administrative Contractors less burdensome.
Regulators have tightened up screening efforts for Medicare providers
By
McKnight's Staff
Apr 24, 2012
Regulators have strengthened Medicare provider enrollment and toughened fraud prevention efforts, but it’s too early to know how effective the initiatives will be, a new report reveals.
Heart failure readmission rates tied to regional socioeconomic factors, research shows
By
McKnight's Staff
May 18, 2012
Socioeconomic differences and factors such as the availability of physicians have a bigger impact on readmission rates for heart failure than a provider’s performance, a new study asserts.
House committee puts Medicare audit contractors on the hotseat
By
McKnight's Staff
Jul 10, 2012
Lawmakers are asking Medicare contractors for more information about how they go about identifying and reporting potentially fraudulent payments to the Centers for Medicare & Medicaid Services.
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...
New Medicaid regulations give states flexibility with home and community based services
By
McKnight's Staff
Apr 10, 2012
State Medicaid programs have been granted additional flexibility in providing home- and community-based services to elderly and disabled individuals, according to new regulations.
CMS frees up $275 million for state coordinated care initiatives
By
McKnight's Staff
Jul 23, 2012
States eager to test payment reform models for federal health programs can apply for awards totaling $275 million, courtesy of the Centers for Medicare & Medicaid Services.