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.
The CMS official in charge of coordinating care for Americans covered by both Medicare and Medicaid says some providers are illegitimately trying to dissuade dual-eligible beneficiaries from participating in a managed-care initiative designed to reduce costs and improve quality.
Medicare should cover annual CT scans for some beneficiaries at high risk of lung cancer, said the CMS Monday in a new proposal that conflicts with a previous recommendation made by a Medicare panel.
The CMS announced late Friday that it will go ahead in January with the rollout of a 5-star rating system for kidney dialysis providers and will use the same methodology that drew harsh criticism from kidney-care groups this summer.
Physicians cheered and jeered parts of a final rule the CMS issued last week that includes Medicare's 2015 physician fee schedule and revised policies on telehealth and other reimbursements. But the potential 21.2% cut to payments driven by Medicare's sustainable growth-rate formula still looms.
A multi-year decrease in the number of children without health insurance has begun to slow, a report found, raising questions as to what role the results of Tuesday's midterm elections may play in future efforts to expand coverage.
Third-quarter profit and revenue fell at HMS Holdings Corp. as the company continues to wait for what the federal government will do with its Medicare auditing program.