Medicare & Medicaid
Physician and pain clinic owner Paramjit Singh Ajrawat, 60, of Potomac, Maryland, has been ordered to repay $3.1 million from a healthcare fraud scheme in which he filed fake insurance claims, according to the U.S. District Attorney's Office in Maryland.
The Affordable Care Act requires states to conduct third-party reviews of Medicaid eligibility before renewing coverage, but a new report by Georgetown University Health Policy Institute has found that legacy technology and a lack of communication can make that difficult.
Executives at University of Rochester Medical Center are so pleased with how the federal government's bundled payment joint replacement program is working that they want to expand it beyond Medicare, James Garnham, who heads bundled payments for the system, said Monday at a hearing on Capitol Hill.
By teaming with community organizations, doctors and hospitals can deliver high-quality care at good value to disadvantaged people at risk for poor health, according to a new report from a panel of experts.
Sharon Iglehart, a former attending psychiatrist at Riverside General Hospital in Houston, has been sentenced to 12 years in prison for her role in a $158 million Medicare fraud scheme involving false claims for mental health treatment.
Template includes coverage examples that demonstrate cost sharing amounts.
The total 3.05 percent rate is less than the total 3.55 percent CMS proposed in February.
Starting April 1, the Centers for Medicare and Medicaid Services will pay an estimated 800 hospitals across 67 metro areas bundled payments for inpatient knee and hip surgeries.
The Centers for Medicare and Medicaid Services will requiring states to provide mental health and substance abuse assistance as they would any other medical services for low-income adults and children.
The policy took effect last year and applies only to Medicare Advantage members, not to the plans CMS oversees in the health law's marketplaces.