Greenville (S.C.) Memorial Hospital risks losing Medicare and Medicaid contracts worth about $500 million every year if it fails to improve processes in its emergency room where a patient died earlier this month.
The U.S. Justice Department has joined another whistle-blower lawsuit against UnitedHealth Group that alleges the insurer fraudulently billed the Medicare program by claiming patients were sicker than they were.
The CMS' decision to delay expansion of a major, mandatory bundled-payment pilot, the Comprehensive Care for Joint Replacement Model, raises questions about the future of such initiatives under the Trump administration.
Low income disabled patients say their care has improved under a federal experiment that allows states test ways to better manage benefits and care for people dually eligible for Medicare and Medicaid, according to a federal audit.
The CMS is trying to boost patient and provider participation in accountable care organizations by automating the process to pair patients with doctors enrolled in the care models.
As the CMS works to remove Social Security numbers from millions of Medicare ID cards, providers are calling on the agency to increase physician outreach efforts to alert them how billing under the program may change.
For now, it's a delay of three months, but the CMS is considering pushing back the Comprehensive Care for Joint Replacement program and its cardiac bundles until 2018.
How provider organizations can leverage MACRA to foster greater collaboration, to enhance care delivery, and improve population health management strategies.
Doctors are potentially facing a loss of millions in Medicare reimbursement dollars due to a lack of MACRA-related guidance from the CMS.
Sign-ups on federal and state-based exchanges were lower than last year.
Doctors may be unknowingly forgoing hundreds of millions in federal funding that would compensate them to better care for the sickest Medicare beneficiaries, and the CMS is launching a national campaign Wednesday to encourage physicians to take advantage of the funds.
The CMS' lack of guidance on a new requirement for hospitals to notify Medicare patients why they are receiving observation care could cause hospitals to lose billing privileges and patients, providers say.