MA plans pocket billions more by enrolling less-costly patients
By
Kimberly Marselas
Jun 16, 2023
Medicare Advantage plans may be receiving overpayments of as much as 20%, finds a new study published by a health and aging think tank.
Office of Inspector General voluntary disclosures — should I or shouldn’t I?
By
Richard Cheng
May 16, 2018
Nursing facility operators might be faced with this dilemma: Should I or shouldn’t I provide an overpayment self-disclosure to the Department of Health and Human Services Office of Inspector General?...
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.
Medicare should reduce payments to SNFs 4% next year, MedPAC says
By
McKnight's Staff
Mar 18, 2013
Medicare payments to skilled nursing facilities should be cut 4% in 2014 and then steadily reduced in subsequent years, the Medicare Payment Advisory Commission said in a March 15 report to Congress. Rates...
CMS ‘overpayment’ rule may come at a greater cost
By
Glenn P. Hendrix
May 02, 2012
The Centers for Medicare & Medicaid Services recently issued a proposed rule addressing how it will implement the 60-day deadline for returning overpayments made to federal health programs. If fully adopted,...
In limbo with underwhelming pay proposal
By
James M. Berklan
Apr 18, 2012
First, it was the U.S. Supreme Court’s turn to leave providers in suspense. Now, it’s a group of decision-makers without robes who have operators holding their breath.
Sharpen Medicaid Integrity auditing, OIG advises
By
McKnight's Staff
Mar 23, 2012
Medicaid Integrity Contractors failed to find overpayments in the majority of their audits for the first half of 2010, leading the Office of Inspector General to recommend that the Centers for Medicare...