News From Around the Web
> Federal agents arrested two individuals linked to, of all things, an adult diaper fraud scam, according to the McAllen Monitor. Court records show that Veronica Vela, the owner of ABC DME in McAllen, Texas, along with her employee, Cynthia Zapata, submitted more than $4.8 million in claims for unnecessary adult diapers between 2005 and 2013. The two ordered the maximum number of allowable diapers in large and extra-large sizes in order to get the highest reimbursement. Article
> Eight people, including a hospital employee, have been indicted for stealing personal information from 12,000 patients at Montefiore Medical Center, located in the Bronx. Monique Walker, who worked as an assistant clerk, used her access to patient files to take names, dates of birth, Social Security numbers and other personal information. She printed the records and then sold them to a co-conspirator, Fernando Salazar, for $3 per record. Salazar provided the information to six other co-defendants who allegedly used the information to make purchases at expensive department stores using store credit and gift cards. Announcement
> An OIG report that evaluated a random sampling of 100 claims indicates that AgeWell Physical Therapy & Wellness P.C. (AgeWell) submitted improper claims for outpatient services. The agency estimated that Medicare paid at least $1.4 million for those services despite the fact that the Bronx-based provider did not have adequate policies to ensure it billed for services appropriately. The OIG recommended that AgeWell reimburse the money and strengthen its billing policies. Report
Health Payer News
> A report from the Congressional Budget Office shows that healthcare insurers would lose 19 million members if the Supreme Court repeals the Affordable Care Act. The report also noted that the repeal would add $350 billion to the federal deficit in the next 10 years because of lower revenue. When factoring the impact on the overall economy, experts said the deficit could be more than half that, at $137 billion. Article
> A house call program saved Medicare $25 million in one year and improved patient care, according to a report from the Centers for Medicare and Medicaid Services. The program, known as the Independence at Home Demonstration, provided tailored treatment for seniors with multiple chronic conditions. Article
And finally … Forget shoes, I wouldn't mind walking a mile in this crust. And sauce. And cheese. Mmm... Article