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 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 overpaymentsFebruary 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.
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.