Medicare Claims

Federal judge OKs statistical sampling of nursing home claims to support fraud charges

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The government can use a statistical sample of a nursing home company's Medicare claims to help prove overbilling charges, a federal judge recently decided in an unprecedented ruling.

Medicare rates could be adjusted for start and end of hospice care episodes, CMS report suggests

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Medicare payments could be adjusted to reflect how hospice services tend to be more intensive at the beginning and end, according to findings recently published by the Centers for Medicare & Medicaid Services Office of Information Products & Data Analytics.

Nursing home provider fails in legal bid against 'extrapolation method' in determining Medicare overpayments

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A government contractor can calculate how much money a provider owes for Medicare overpayments by doing a limited audit and then extrapolating from those findings, a federal appeals court recently affirmed.

Faster payments for 'trusted' providers?

Faster payments for 'trusted' providers?

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Rep. Roger W. Williams (R-TX) has introduced a "trusted provider" bill in the House of Representatives. The measure would give Medicare claim review protections for those who pose a lower risk of submitting fraudulent claims.