RACs identify fraud cases and improper payments The Centers for Medicare & Medicaid Services (CMS) conducted a demonstration project from 2005 to 2008 to detect and correct past improper payments in the Medicare fee-for-service program, and to provide information to CMS and the Medicare claims processing contractors that could help protect Medicare trust funds by […]
Expect More Programs Like Recovery Audit Contractors President Obama signed a presidential memorandum directing all federal departments and agencies to “expand and intensify their use of payment recapture audits under their current authority,” on March 10. No additional legislation is needed, therefore, for the agencies to enact programs similar to CMS’s Recovery Audit Contractors program. […]
Restructure Will Happen Before CMS Gets a New Chief The Centers for Medicare & Medicaid Services (CMS) is being restructured, despite lacking a Senate-confirmed administrator since the last one stepped down October 2006. The new structure adds a new pricipal deputy administrator, reporting directly to Acting CMS Administrator Charlene Frizzera. Firzzera announced the changes Feb. […]
AMA Letter to Senate: Repeal Medicare Payment Formula This Month The AMA issued a statement calling on the Senate to “use this time wisely to repeal a broken payment formula.” The House has passed legislation that would have repealed the funding formula, and now the Senate needs to act, according to the statement. The […]
Scheduled 21% Pay Cut for Physician Services to Medicare Beneficiaries Delayed 30 Days On March 2, the US Senate once again delayed enacting a scheduled 21% payment cut for physicians who provider Medicare services. The lopsided vote, 78-19, concerns the Temporary Extension Act of 2010 (H.R. 4691), and includes extensions to unemployment benefits, and […]
Senator Ted Kaufman (D-DE) introduced the Health Care Fraud Enforcement Act of 2009, co-sponsored by Committee Chairman Patrick Leahy (D-VT) and Committee members Arlen Specter (D-PA), Herb Kohl (D-WI), Chuck Schumer (D-NY) and Amy Klobuchar (D-MN), on October 28, 2009, follwing a Senate Judiciary Committee hearing on “Effective Strategies for Preventing Health Care Fraud.” This […]
AIS Publications – Aug 28, 2009. Health care organizations have more reason than ever to keep employees from snooping into patient records. New laws at the federal level, and in some states, make it clear that letting nosy employees slide is no longer an option. Click title to read more… The HITECH Act’s definition […]
HealthLeaders Media, August 26, 2009. It isn’t every day that rural hospital officials eagerly discuss their abysmal practice scores in crucial care areas like heart failure or hip and knee surgery. But Cleveland Regional Medical Center in Shelby, NC, and United Hospital Center in Clarksburg, WV, now wear their low rankings almost like war medals. […]
The U.S. District Court for the District of Delaware declined to apply the 2009 False Claims Act (FCA) Amendments against a physician’s submitted false claims prior to 2009 because no false claims were paid by the government and application of the amendments would have caused retroactive effects counter to congressional intent, as reported by CCH® […]