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...
Poorly coded doctor claims cost Medicare $33 million: OIG report
By
John Hall
May 11, 2015
The Health & Human Services’ Inspector General is advising the agency to have its Medicare contractors chase down more than $33 million that might have been overpaid to physicians as a result of...
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...
Joint HHS, Justice efforts recoup $28 billion in Medicare payments
By
John Hall
Mar 19, 2015
The Justice Department announced on Thursday it had captured $3.3 billion from healthcare fraud prosecutions and other deals in 2014, bringing to nearly $28 billion the total amount it has recouped since...
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...
Budget cut-hungry GOP walks fine line, eyeing 2016 elections
By
John Hall
Apr 21, 2015
House and Senate Republican lawmakers began working on a budget this week that could propose slashing Medicare and Medicaid in an effort to work toward a balanced budget without fiddling with tax rates,...
Congress mulls Medicaid-Medicare pay parity, and end of ‘doc fixes’
By
John Hall
Mar 16, 2015
Long-term care providers are closely monitoring two major lawmaking efforts in Washington this week that have both chambers of Congress debating a plan to end annual Medicare cuts and abolish painful “fixes”...
‘Observation status’ provision under further review
By
John Hall
Feb 27, 2015
The American Health Care Association on Thursday applauded a House measure that would inform Medicare beneficiaries of their observation status as hospital inpatient or outpatients. But that might be little...
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...
CA man gets 30 months in prison, hefty fine in clinic ‘fraud’ case
By
John Hall
Apr 09, 2015
A San Diego man will serve 2½ years in custody after being ordered to repay the government nearly $1 million for what prosecutors say were phony Medicare claims for medically unnecessary and unsupervised...