Reimbursement
A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices.
The state of Maryland is proposing significant changes to how its Medicaid system doles out cash to methadone treatment clinics.
The clinical director of a Massachusetts home nursing agency, along with the agency's co-conspiring owner and doctor who served as the agency's medical director, have been sentenced in U.S. District Court in Boston for healthcare fraud and other charges in a multi-million dollar Medicare fraud scheme, the FBI and U.S. Attorney's office announced in a Dec. 22 statement.
The state of Maryland is proposing significant changes to how its Medicaid system doles out cash to methadone treatment clinics. And some operators of such facilities aren't happy about it.
Coloplast Corp, an ostomy and continence care product manufacturer, has agreed to pay $3,160,000 to settle allegations it paid illegal kickbacks to a number of medical suppliers. Liberator Medical Supply Inc., one of five companies named in the kickback scheme, has agreed to pay $500,000 for their part, the U.S. Attorney's Office announced through a statement released Dec. 22 by the Boston Division of the FBI.
A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices. That's the word from the Centers for Medicare and Medicaid Services, after issuing its final rule Tuesday establishing a prior authorization process for certain durable medical equipment, prosthetics, orthotics and supplies.
Health plans reimbursed customers approximately $478 million in 2014, translating to about $129 per family receiving a refund, according to data aggregation firm Mark Farrah Associates.
Saint Peter's sued Horizon over what it said was its wrongful exclusion.
The Patient Access and Medicare Protection Act, which was recently passed, will hold Medicare reimbursement rates steady for freestanding radiation oncology centers. Additionally, two providers listed as B3 stable, 21st Century Oncology and Vantage Oncology, will see their 2016 rates hold steady for 2017-18, according to a report from Moody's Investor Service.
The co-owners of a Dallas-based home health business as well as two nurse employees have been charged with conspiracy and fraud for allegedly submitting false claims to Medicare for $13.4 million dollars, according to the FBI.