Medicare & Medicaid
Officials say Ubert Guillermo Rodriguez billed Medicare for $2.57 million in reimbursements between May and July 2013 for medical equipment that was never prescribed by a doctor and never delivered to patients.
The Centers for Medicare and Medicaid continues to see improvement in the number of beneficiaries enrolled in high-performing Medicare Advantage plans, according to its 2016 Star Ratings released on October 8.
A new report by the Health Research Institute of PricewaterhouseCoopers says the transformation from fee-for-service to value-based reimbursement will take longer than the ambitious timeline announced in January by Health and Human Services Secretary Sylvia Burwell.
CareDx in California is pushing the Centers for Medicare and Medicaid Services to keep the current reimbursement price for its heart transplant blood test AlloMap, or the company may have to close, according to CEO Peter Maag.
Over 385,000 providers referred products such as wheelchairs, walkers and diabetes supplies in 2013, according to CMS.
The program decreased Medicare Part A and Part B spending compared to targets.
The Centers for Medicare and Medicaid Services on Tuesday launched a new accountable care model for kidney care companies, linking dialysis facilities, nephrologists and other providers in more than a dozen ACOs that will share in the risk associated with treating Americans with end-stage renal disease.
While the practice has been optional so far, in early 2017 providers must submit four of their inpatient quality reporting measures electronically, dubbed eCQM, or they will receive a 25 percent reduction in their Centers for Medicare and Medicaid Services market basket update in 2018.
Guardian submitted false claims for hospice care for patients who did not have a terminal prognosis of six months or less, according to authorities.
Earlier this year Medicare gave bonuses to 1,700 hospitals and reduced payments to 1,360 hospitals based on their mortality rates, patient reviews, degree of improvement and other measurements.