Medicare & Medicaid
Dike Ajiri, chief executive officer at Chicago-based Mobile Doctors, recently plead guilty to charges that he fraudulently billed Medicare for in home-treatments that were longer than they actually were.
More than 1,800 hospitals will see payments from the federal government rise in 2016 due to improvements in quality under the Centers for Medicare and Medicaid Services value-based purchasing program, CMS said Monday, with 600 more hospitals receiving increases than the prior year.
The medication therapy management model is being tested in five regions as an incentive to boost adherence for stand-alone Part D plans not connected with Medicare Advantage.
A key strategy for Medicare is encouraging doctors, hospitals and other health care providers to form accountable care organizations (ACOs) to coordinate beneficiaries' care and provide services more efficiently.
Dartmouth-Hitchcock Medical Center will abandon the Pioneer Accountable Care Organization program, the system confirmed Tuesday, after losing more than $3 million over the past two years in the Centers for Medicare and Medicaid model.
Millennium Health of San Diego has agreed to pay $256 million to the federal government to resolve claims that it billed Medicare, Medicaid and other federal healthcare programs for medically unnecessary urine drug and genetic testing, according to the U.S. Department of Justice.
The governor and state lawmakers are using a mixture of healthcare models to put the major players -- doctors, hospitals and insurers -- all on the hook to keep rising costs in check.
Tuomey Healthcare System in South Carolina will pay the federal government $72.4 million and will affiliate with Palmetto Health to resolve claims it billed Medicare for services referred by physicians it illegally paid, according to the U.S. Department of Justice.
Medicaid spending soared nearly 14 percent last year--its biggest annual increase in at least two decades--as a result of millions of newly eligible low-income enrollees signing up under the Affordable Care Act, according to a report released Thursday by the Kaiser Family Foundation.
More than $240 million is being pumped into the National Health Service Corps and NURSE Corps scholarship and loan repayment programs as incentive for primary care clinicians to practice where they are needed most, Health and Human Services Secretary Sylvia Burwell announced Wednesday.