Federal judge OKs statistical sampling of nursing home claims to support fraud charges
By
Tim Mullaney
Oct 06, 2014
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
By
Tim Mullaney
Jul 31, 2014
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...
Nursing home provider fails in legal bid against ‘extrapolation method’ in determining Medicare...
By
Tim Mullaney
Feb 18, 2014
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?
By
John O'Connor
Dec 01, 2013
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...