Medical Billing Blog

Justice Department Joins Lawsuit of Medicare Fraud by UnitedHealth

Posted by Scott Shatzman on Thu, Mar, 30, 2017 @ 08:03 AM

The Justice Department has joined a California whistleblower’s lawsuit that accuses insurance giant UnitedHealth Group of fraud in its popular Medicare Advantage health plans.

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HHS Secretary: Medicare Balance Billing + MACRA

Posted by Scott Shatzman on Thu, Mar, 16, 2017 @ 09:03 AM
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CMS: Campaign to Promote Coordinated Care Program

Posted by Scott Shatzman on Wed, Mar, 15, 2017 @ 14:03 PM
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High-Deductible Plans: A Physician's Experience

Posted by Scott Shatzman on Wed, Feb, 08, 2017 @ 08:02 AM

All the doctor’s tricks were failing him. He’d tried neck massage, pressure to the eyes, ice on the face. But an hour in, Ashish Jha still couldn’t slow his racing heart.

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Tom Price: HHS Pick Favored Drugmakers, Device Makers and Doctors

Posted by Scott Shatzman on Tue, Jan, 31, 2017 @ 09:01 AM

As Cabinet nominee Tom Price faces a Senate confirmation hearing Tuesday, a newly released trove of documents sheds further light on how he interacted as a congressman with the Centers for Medicare and Medicaid, the massive agency he may soon oversee.

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Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show

Posted by Scott Shatzman on Wed, Jan, 11, 2017 @ 11:01 AM

Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services.

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HHS Nominee Not a Fan of Bundled Payments

Posted by Scott Shatzman on Tue, Jan, 10, 2017 @ 10:01 AM

A recent change in the way Medicare pays for joint replacements is saving millions of dollars annually — and could save billions — without impacting patient care, a new studyhas found. But the man Donald Trump has picked to be the secretary of Health and Human Services has vocally opposed the new mandatory payment program and is likely to revoke it.

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CMS Shifts Strategy to Combat Fraud

Posted by Scott Shatzman on Fri, Jan, 09, 2015 @ 08:01 AM

Dr. Shantanu Agrawal, MD, the Director of CMS’ Center for Program Integrity (CPI) stated that CPI is going to shift its focus to preventing fraud rather than chasing overpayments down after they have already been paid.  In a speech to the American Bar Association’s Health Law Summit, Agrawal said that “preventative actions have a greater return on investment than the pay and chase model, in which the government seeks the return of overpayments it has already made”.   

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AMA Releases List of 8 EHR Priorities

Posted by Scott Shatzman on Thu, Oct, 09, 2014 @ 07:10 AM

Following widespread discontent with the meaningful use program and EHR policies, the American Medical Association (AMA) has released a list of eight priorities to improve quality and usability during EHR adoption.

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Six States and D.C. Extend Medicaid Pay Raise for Primary Care Doctors

Posted by Scott Shatzman on Tue, Aug, 26, 2014 @ 09:08 AM

Six states and the District of Columbia. will use their own money in 2015 to sustain the federal Medicaid pay raise to primary care doctors. The pay raise stems from a provision of the Affordable Care Act (ACA) that expands Medicaid fees for primary care to the same amount paid under Medicare. The states are Maryland, Colorado, New Mexico, Iowa, Alabama, and Mississippi. Interestingly, Mississippi and Alabama did not participate in the Medicaid expansion under the ACA.

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