Medicare & Medicaid
The Medicare Payment Advisory Commission and other organizations representing Medicare Advantage plans that serve low income and disabled populations say two options for interim relief on star quality ratings do not go far enough to address how socioeconomics affect scores.
The Centers for Medicare & Medicaid Services, in tandem with the Office of the National Coordinator for Health IT, issued a request for information this week -- wanting to hear from providers and vendors as the agencies look to reduce the burden of reporting clinical quality measures.
Sentencing continues for family members involved in a Medicare Part D fraud scheme that bilked the system for more than $20 million and saw its perpetrators using the funds to buy luxury cars and fund other businesses, said the FBI and the U.S. Attorney's Office, Southern District of Florida.
A nonprofit specializing in financial assistance for underinsured Americans has opened a new fund to provide help to Medicare patients suffering from renal cell carcinoma. It is the second fund launched this month by the HealthWell Foundation, an independent organization which provides a financial safety net for more than 200,000 underinsured patients by facilitating access to otherwise unaffordable medical treatments.
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.
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.
WellCare, a publicly traded insurer based in Florida, has filed a lawsuit against the Department of Human Services in Iowa, contesting its nixed contract to help oversee the state's Medicaid program.
Men are getting more screening colonoscopies since the health law reduced how much Medicare beneficiaries pay out of pocket for the preventive tests, a recent study found. The change, however, didn't affect women's rates.
WellCare Health Plans, Inc., a managed care service provider for government-sponsored healthcare programs, is enhancing their Medicaid benefits in Kentucky by offering several new programs aimed at preventative health, the company announced through a statement. The new benefits take effect January 1, 2016.
Hospital giant HCA will pay $2 million to settle a whistleblower lawsuit alleging that medically unnecessary and substandard heart surgeries were being performed at Fairview Park Hospital in Dublin, Georgia, the U.S Department of Justice said Tuesday.