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.
Medical Billing Blog
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.
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.
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.
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.
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”.
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.
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.