Tag Archives: cms

House Sees More Work Ahead on Medicare Fraud

House Lawmakers Say New Efforts to Limit Medicare Fraud Aren’t Doing Enough The Centers for Medicare and Medicaid Services says it has revoked the billing privileges of more than 20 thousand Medicare providers and suppliers since the implementation of the … Continue reading

Posted in NEWS | Tagged , , | Comments Off on House Sees More Work Ahead on Medicare Fraud

Home Health Claims Lack Required Documentation

A new HHS OIG report finds that 32 percent of home health claims that required face-to-face encounters, the documentation did not meet Medicare requirements, resulting in $2 billion in payments that should not have been made. Furthermore, physicians inconsistently completed … Continue reading

Posted in NEWS | Tagged , , | Comments Off on Home Health Claims Lack Required Documentation

Insurance Company Cheated Medicare Out of $1 Billion, Says Lawsuit

Josh Valdez took an executive level job in April 2010 expecting to improve medical services at two Puerto Rican Medicare Advantage health plans owned by a subsidiary of New Jersey company: Aveta Inc. But a few months after coming on … Continue reading

Posted in NEWS | Tagged , , , , , , , | Comments Off on Insurance Company Cheated Medicare Out of $1 Billion, Says Lawsuit

CMS Updates Two-Midnight Guidance to Reflect Latest Implementation Delay

The Centers for Medicare & Medicaid Services (CMS) updated May 12 its guidance on inpatient hospital reviews to implement delays in enforcing its so-called “two-midnight” policy through March 31, 2015 as called for under the Protecting Access to Medicare Act of 2014. … Continue reading

Posted in NEWS | Tagged , , , | Comments Off on CMS Updates Two-Midnight Guidance to Reflect Latest Implementation Delay

Medicaid Enrollment Grows by More than 3 Million

Because of the Affordable Care Act, 7.1 million people have signed up for quality, affordable, private health insurance options in the Health Insurance Marketplace through March 31. And, according to a new CMS report released today, 3 million additional individuals … Continue reading

Posted in NEWS | Tagged , , | Comments Off on Medicaid Enrollment Grows by More than 3 Million

Medicare Physician’s Payment Data Released

The Obama administration decided last week to make all Medicare payment information public. A scholar at the American Enterprise Institute, Joe Antos reported according to Bloomberg News that, this information “will benefit not just consumers and the taxpayers but ultimately … Continue reading

Posted in NEWS | Tagged , , | Comments Off on Medicare Physician’s Payment Data Released

RACs Identified $2.4B In Improper Payments in FY2012

Recovery Audit Contractors (RACs) identified $2.4 billion in improper Medicare fee-for-service (FFS) payments in fiscal year (2012), the Centers for Medicare & Medicaid Services (CMS) reported to Congress. Of that amount, $2.3 billion involved collected overpayments, while $109.4 million was … Continue reading

Posted in NEWS | Tagged , | Comments Off on RACs Identified $2.4B In Improper Payments in FY2012

CMS Shelves Controversial Part D Proposals

The Centers for Medicare & Medicaid Services (CMS) will not finalize at this time several controversial changes to the popular Medicare Part D program that were included in a recent proposed rule, according to a March 10 letter from CMS … Continue reading

Posted in RESOURCES | Tagged , | Comments Off on CMS Shelves Controversial Part D Proposals

CMS Posts Updates on Probe Educate Audits for Two Midnight Rule

The Centers for Medicare & Medicaid Services (CMS) posted February 24 additional updates on the “probe and educate” audits it is conducting in connection with new payment policies for Medicare Part A inpatient claims. Under the 2014 Inpatient Prospective Payment … Continue reading

Posted in NEWS | Tagged , , | Comments Off on CMS Posts Updates on Probe Educate Audits for Two Midnight Rule

HIPAA Privacy Rule and Sharing Information Related to Mental Health

The Department of Health and Human Services Office for Civil Rights (OCR) moved to clarify further when and how health care providers can disclose mental health information to a patient’s family or caregivers without viewing the the Health Insurance Portability … Continue reading

Posted in RESOURCES | Tagged , , | Comments Off on HIPAA Privacy Rule and Sharing Information Related to Mental Health