Medicare Fraud Sweep Nets $223 Million, 89 Arrests for False Billings

A nationwide takedown by Medicare Fraud Strike Force operations in eight cities has resulted in 89 arrests for alleged participation in Medicare fraud schemes involving $223 million in false billing, the Department of Health and Human Services (HHS) announced Wednesday. The cumulative arrests represented the sixth national Medicare fraud takedown in the Strike Force’s history, […]

Senior Care Costs Grew at Slowest Rate of All Age Groups: CMS

Health care spending for seniors grew at the slowest rate compared to other age groups between 2002 and 2010, according to a new actuarial report from the Centers for Medicaid & Medicare Services. The average annual growth in per-person personal health care spending for seniors was 4.1% during that eight-year time frame—the lowest among any […]

Senator Launches Effort to Postpone Competitive Bidding Expansion

A U.S. Senator has spearheaded a sign-on letter asking the Centers for Medicare & Medicaid Services to postpone plans to expand the competitive bidding program for home medical equipment. Senator John Hoeven (R-N.D.) launched the effort in response to a recent announcement that competitive bidding will be expanded nationwide by 2016 beyond the 100 areas […]

CMS Proposes to Bump Hospice Medicare Payments Up $230 Million for 2015

Hospices serving Medicare beneficiaries may see a $230 million, or 1.3%, payment increase in their reimbursements for fiscal year 2015, according to a recent proposal from the Centers for Medicare & Medicaid Services (CMS). On May 2, CMS proposed an update to the wage index and payment rates for the Medicare Hospice Benefit.  The payment […]

Push Against Competitive Bidding Goes National

A growing group of professionals with ties to the home care and medical equipment industries are uniting in their opposition to a proposal from the Centers for Medicare and Medicaid Services (CMS) to expand its competitive bidding program to new areas.  From clinicians and advocates for Medicare beneficiaries to home medical equipment providers, manufacturers, and […]

Face-to-Face Rule Burdensome to Home Health Agencies

New government rules meant to prevent inappropriate reimbursements are proving burdensome to many home health agencies who worry it will interfere with their ability to provide care to those who need it.  “The cost of caring for homebound patients is rising, and the government is trying to get a better grip on spending by requiring […]

CMS Readies Fingerprint Background Checks for Home Health Providers

The Centers for Medicare & Medicaid Services (CMS) will finally begin implementing its long-heralded fingerprint-based background checks for home health providers. As part of enhanced enrollment screening provisions contained in the Affordable Care Act, CMS announced it is beginning to phase in the implementation of fingerprinting background checks—an initiative three years in the making. The […]

OIG Finds $2 Billion in Medicare Home Health Claims Paid in Error

Federal investigators have uncovered some flaws with the Centers for Medicare & Medicaid Services’ (CMS) face-to-face rule—flaws costing $2 billion worth of erroneous home health Medicare claims, a recent report finds.  Documentation standards for face-to-face encounters did not meet Medicare requirements for 32% of home health claims, resulting in $2 billion that should not have […]

OIG Reviews DME Competitive Bidding Program

The Centers for Medicare & Medicaid Services (CMS) generally operated within the guidelines and Federal requirements for the competitive bidding Round 1 rebid program for durable medical equipment suppliers, the Department of Health & Human Services’ Office of the Inspector General found in a recent report.  “We determined that CMS generally selected DMEPOS (durable medical equipment, […]

CMS To Begin Data Collection for Hospice Quality Reporting

The Centers for Medicare and Medicaid Services will begin a new data collection to inform hospice quality reporting, according to a Federal Register notice published this week.  In accordance with the Privacy Act of 1974, CMS is establishing a new system, the Hospice Item Set System, to support the collection of data required for the […]