Reimbursement news and information

The GAO reported that 91% of hospitals paid by Medicare receive some dispensation or add-on to the program's standard payment system.
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As the deadline nears for Medicare's first accountable care organizations to decide whether they will continue with the initiative, at least one is debating whether to leave.
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Senate Finance Committee Chairman Max Baucus opened the panel's first hearing in six years on Medicare physician pay with assertive rhetoric about scrapping the hated sustainable growth-rate formula this year. .
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Because of the program's history of low payments, fewer than half of U.S. doctors and other healthcare professionals accept Medicaid patients, according to a recent study. For those that do, getting an appointment sometimes can take months because of the high demand, particularly among specialists.
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Physician advocates see signs of progress in the Senate Finance Committee's hearing Tuesday—the panel's first in six years on replacing Medicare's physician payment system.
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The CMS and Medicare beneficiaries could have saved an estimated $510 million on drugs used to treat end-stage renal disease in 2011 if the reimbursement rate more accurately reflected current usage of these drugs, according to a report from HHS' inspector general's office.
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A, jury concluded that Tuomey Healthcare in Sumter, S.C., violated the False Claims Act by submitting tens of thousands of illegal bills to Medicare worth $39 million.
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Providers are coalescing around a five-year transition period before moving to a new Medicare physician payment system, according to a House Republican involved in developing the replacement.
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HHS' inspector general's office is launching an in-depth investigation into cases where Medicare hospice beneficiaries get inpatient care, following unusual billing patterns that surfaced during recent research on the $1.1 billion industry.
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LIVONIA, Mich.—Blue Cross and Blue Shield of Michigan and Trinity Health-Michigan have signed a three-year reimbursement contract that gives Trinity's 12 hospitals in Michigan financial incentives for improving care with affiliated physicians. Blue Cross has similar contracts with...
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