Fee-for-service still consumes most Medicare outlays: Report
By
John Hall
May 07, 2015
Far more than half of the $360 billion in Medicare payments made just two years ago were based on traditional fee-for-service models without regard to quality or value, according to an independent report...
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...
Nursing homes blamed for high opt-out rates in dual eligible demo
By
John Hall
May 18, 2015
Huge numbers of dual-eligible beneficiaries are leaving a demonstration project that hopes to improve payments for people eligible for both Medicare and Medicaid.
CMS actuary throws cold water on ‘doc fix’ bill projections
By
John Hall
Apr 12, 2015
Long-term care leaders who have widely endorsed a House proposal to permanently “fix” the Sustainable Growth Rate formula, might be suffering buyer’s remorse after learning Friday that...
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...
New Medicare ACO to be unveiled soon
By
John Hall
Mar 02, 2015
The government’s top health insurer has announced that providers could get a first look at a new type of Medicare accountable care organization this month. It has been modeled closely after a controversial...