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Medicare

Latest Headlines

Latest Headlines

Another Pioneer ACO drops out of program

Sharp HealthCare in San Diego dropped out of the Medicare Pioneer accountable care organization program, citing fundamental flaws in the program, according to the company's third quarter financial statement.  

American Hospital Association calls for end to OIG audits

The American Hospital Association called on the U.S. Department of Health and Human Services to cease what it calls "flawed and redundant" audits by its Office of the Inspector General in a letter to HHS Secretary Sylvia Burwell.

Fighting prescription drug fraud: 2 wins and a delay

The federal government scored big wins against prescription drug fraud last week, while New Jersey pushed back its implementation deadline for providers' use of securer prescription pads.  

Radiology managers still skeptical about Medicare reimbursements

Medical imaging managers and directors continue to have low confidence that they will be adequately reimbursed by Medicare for diagnostic and interventional imaging services.

CMS solicits ideas for engagement models

The Centers for Medicare & Medicaid Services is soliciting comments through Sept. 15 about its proposed initiatives to test new engagement models for Medicare, Medicaid and the Children's Health Insurance Program.

EHR billing fraud: More than a numbers game

There's a well-known adage in business that 10 percent of people will never steal, embezzle or commit fraud; 10 percent will always steal, embezzle or commit fraud when they can; and 80 percent will do it under certain circumstances when given the opportunity. That might finally explain what's occurring with electronic health records and billing fraud.

Wheelchair scams exploit Medicare fraud risks, but what's next?

Fraud schemes involving power wheelchairs have exposed Medicare's fat and vulnerable underbelly, according to an article in The Washington Post. "Since 1999, Medicare has spent $8.2...

Feds fight uphill battle in fraud crackdown

Law enforcement officials estimate that fraud drives up to 10 percent of Medicare's annual spending, but recovering that money and preventing more losses can be a David-and-Goliath fight, according to reports in the New York Times and the Wall Street Journal.

U.S. Senator: For-profit hospitals drive up care costs

For-profit hospitals and hospital chains change the way healthcare is delivered in the U.S., and often drive up the cost of care, according to Connecticut's junior senator.

CMS to compensate docs' care coordination for chronically ill

Amid evidence that better care-coordination means improved outcomes, and fewer mistakes and costly hospitalizations, the Obama administration issued a policy change whereby the Centers for Medicare & Medicaid Sericies will pay physicians a monthly fee to coordinate care for Medicare beneficiaries with two or more chronic conditions, the  New York Times  reported.