The owner and operator of a Miami home health care company recently was sentenced for her part in a $6.5 million Medicare fraud scheme, after falling into the cross-hairs of the federal government’s Health Care Fraud Prevention and Enforcement Action Team (“HEAT”).
The Small Business Jobs Act of 2010 (pertinent sections of which are codified at 42 U.S.C. Section 1320a-7m) directed the Centers for Medicare & Medicaid Services (CMS) to use predictive modeling and other analytics technologies to identify and prevent fraud, waste, and abuse in the Medicare fee-for-service program.
Medicare Announces Pay Increases for Psychiatric, Skilled Nursing and Rehabilitation Providers in Fiscal Year 2015
According to the rules released last Thursday by the Centers of Medicare and Medicaid Services (CMS), Medicare will increase payment to inpatient psychiatric hospitals, inpatient rehabilitation facilities and skilled nursing facilities in fiscal year 2015.
While the rest of us were heading out the door for the holiday weekend, the Centers for Medicare & Medicaid Services (CMS) in the late afternoon of July 3 posted the proposed 2015 Medicare Physician Fee Schedule.
CMS Seeks to Update Payment Rates and Eligibility Certification Requirements in Proposed Rule for Medicare Home Health Services
On July 7, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule updating Medicare’s Home Health Prospective Payment System payment rates for 2015.
A review of Medicare Part B claims for evaluation and management (E/M) services conducted by the Office of the Inspector General (OIG) has found that the program paid $6.7 billion in improper payments in 2010.
CMS Finalizes Medicare Part C and Part D Program Changes for Contract Year 2015: Moderate Deviations from Proposed Rule
On January 8, 2014, we noted several proposed changes to the Medicare Part C and D programs as delineated in CMS’ January 8th proposed rule (hereinafter “Proposed Rule”).
Kaiser Health News had an article about the new requirement in ObamaCare that requires Medicare to cover a screening for cognitive impairment during an annual wellness visit. Dementia screening tests are typically short questionnaires that assess such things as memory, att
DOJ: Medicare Fraud Strike Force Charges 90 Individuals for Approximately $260 Million in False Billing
The U.S. Department of Justice issued a press release (the “press release”) covering today’s announcement by Attorney General Eric Holder and Department of Health & Human Services (HHS) Secretary Kathleen Sebelius that Medicare Fraud Strike Force operations in six cities resulted in charges against 90 individuals, including 27 doctors, nurses and other medical professionals, for their alleged participation in fraud schemes involving approximately $260 million in Medicare false claims.