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.
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.
House Republicans are circulating a proposal to overhaul the way Medicare pays hospitals for short stays, including a plan to eliminate the widely criticized “two-midnight rule.”
Hospitals will have an extra month to attest to having met the criteria to receive incentive payments for meaningfully using electronic health records, the CMS said Monday.
Were patients really sicker? Lawsuits say Medicare Advantage plans inflated diagnoses to boost payments
Critics say the Medicare Advantage program's patient risk-score payment model offers a strong incentive to manipulate the scores, though plans say allegations of improper scoring are a result of invalid audit methods.
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.
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.
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.
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.
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.
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.
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.