Five people have been sent to federal prison for their roles in a $25 million Medicare fraud scheme that involved people from Nicaragua and the Dominican Republic posing as U.S. patients.
In an effort to improve outcomes at the nation's 6,000 dialysis facilities, Medicare plans to cut reimbursement rates up to 2% if the facilities perform poorly on an expanded set of quality metrics.
For decades, the nation has poured hundreds of billions of dollars into basic and applied science to devise cures for diseases. But investing in research and development for new and better ways of delivering care in hospitals and physician offices remains a stepchild in Washington.
The CMS wants to cut reimbursement rates for outpatient services. Provider groups immediately slammed the proposals, saying they undervalue outpatient care.
The CMS plans to soften but keep the controversial "two-midnight" rule governing short hospital stays in spite of aggressive calls from providers and policy experts to abandon the policy.
Federal prosecutors have reached a $20.3 million civil settlement with Community Health Network to resolve allegations of overbilling for surgeries.
Kidney-care providers could see their Medicare payments reduced by up to 2% in the next few years if they do not score high enough on quality measures.
Paul Kusserow, president and CEO of Amedisys, discusses the company's management shake-up, its expansion strategy and its moves toward risk contracting.
Data Points for the week of June 29, 2015, covered the following topics: overdose reversals, life expectancy gains, obesity, the ACA and Medicare Part D
The CMS proposed a 0.3% rate increase for end-stage renal disease services for 2016. The proposal also modifies Medicare's quality incentive program for dialysis providers.
The CMS is making it easier for rural healthcare providers and small physician groups to participate in Medicare accountable care organizations.
Of the 18 physicians identified so far in last week's national Medicare fraud takedown, more than half collected at least three times as much from Medicare as the average doctor in their specialty, according to Medicare physician payment data for 2013.