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Insurers say they can't help dual-eligibles if they can't find them

By Virgil Dickson  |  November 26, 2014

Bad contact and demographic information for people dually eligible for Medicare and Medicaid is complicating demonstration programs intended to coordinate and improve the quality of their care, according to insurers participating in the program.

CMS considers coverage of dual testing for cervical cancer

By Virgil Dickson  |  November 26, 2014

The CMS has decided to follow the American Academy of Family Physicians' suggestion that it begin a national coverage analysis to determine if the agency should pay for women to get a combination Pap smear and HPV test every five years to screen for cervical cancer.

Growing community-based doctors

Growing community-based doctors

By Andis Robeznieks  |  November 22, 2014

Around the country, a number of graduate medical education programs are training young doctors in community-based medicine, in the hope that they'll either stay where they are trained or relocate to other underserved communities.

Another $2 billion-plus year for DOJ healthcare recoveries

Another $2 billion-plus year for DOJ healthcare recoveries

By Lisa Schencker  |  November 20, 2014

The Justice Department recovered $2.3 billion from alleged healthcare fraud schemes in fiscal 2014, down slightly from the $2.6 million it collected the year before, it announced Thursday morning.

Can MedPAC make the two-midnight rule go away?

By Virgil Dickson  |  November 18, 2014

The Medicare Payment Advisory Commission is mulling trying to solve the conundrum posed by the widely panned “two-midnight rule” by eliminating the outpatient observation claims that gave rise to it.

Big-city hospitals more likely to face readmission penalties

By Sabriya Rice  |  November 17, 2014

Hospitals in Chicago, Detroit, New York City, Newark, N.J., and Philadelphia saw the highest average Medicare readmission penalties over the past two reporting periods, according to researchers studying the impact of the program on urban institutions.

Florida home healthcare owner pleads guilty in fraud scheme

By Lisa Schencker  |  November 13, 2014

A former owner of a Miami home healthcare company has admitted that he and others paid kickbacks and bribes to patient recruiters to help them fraudulently bill Medicare $30 million, the U.S. Justice Department announced Thursday.

SGR, CHIP fixes potentially on lame-duck agenda, but prospects look slim

SGR, CHIP fixes potentially on lame-duck agenda, but prospects look slim

By Paul Demko  |  November 12, 2014

The only major task likely to get done during the four-week lame-duck session will be to provide continuing funding for the federal government, which is slated to run out of money Dec. 11. But that isn't stopping healthcare groups from pushing for action.

Pioneer ACOs can recruit seniors under new CMS test

Pioneer ACOs can recruit seniors under new CMS test

By Melanie Evans  |  November 11, 2014

Accountable care organizations have expressed frustration that patients assigned by Medicare have too little allegiance to the doctors and hospitals working to coordinate their care.

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