Improper Medicare payments down $20.7B since 2014, CMS data show
FierceHealthIT
NOVEMBER 16, 2021
Improper Medicare payments down $20.7B since 2014, CMS data show. Tue, 11/16/2021 - 07:15.
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FierceHealthIT
NOVEMBER 16, 2021
Improper Medicare payments down $20.7B since 2014, CMS data show. Tue, 11/16/2021 - 07:15.
FierceHealthIT
NOVEMBER 14, 2018
A nuanced legal battle over Medicare Advantage overpayments rages on. CMS will appeal a September ruling invalidating a 2014 rule with huge implications for insurers, including UnitedHealth.
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FierceHealthIT
SEPTEMBER 7, 2018
judge invalidated a 2014 rule that required Medicare Advantage insurers to report and return overpayments associated with incorrect diagnosis codes. On Friday, a D.C. The ruling could have a huge impact on an ongoing case against UnitedHealth and a federal investigation into Anthem's MA plans.
Health Populi
FEBRUARY 21, 2023
This has been a consistent health consumer sentiment for a long time: here’s how I covered PwC’s study on The Wearable Future back in 2014. ” As employers increasingly pay attention to worker wellness and population health, the enterprise-coverage vision that PwC began to quantify in 2014 is (finally) gaining traction.
BHM Healthcare Solutions
OCTOBER 2, 2018
Editor’s Note: Medicare Advantage organizations (MAOs) continue to do a poor job of maintaining accurate provider directories—and it’s landing some in hot water with the federal government. The OIG’s report, released in September, found Medicare Advantage organizations overturned about 216,000 denials annually during the period.
Chilmark Research
SEPTEMBER 26, 2014
Medicare’s Pioneer program down to 19 ACOs after three more exit. “Although it was based on a small sample size, Kaufman Hall found inpatient utilization rates either unchanged or down for a majority of nonprofit hospitals through the first 2 quarters of 2014. And plenty of other great reading too. ” – Matt.
Health Populi
JUNE 18, 2021
workers with private insurance more likely report poor access to health care, greater costs of care, and lower satisfaction with care versus people covered by public health insurance plans — whether Medicaid, Medicare, VHA or military coverage. Health Populi’s Hot Points: U.S. households.
Health Populi
APRIL 8, 2019
That retirement cost gap is the sticker-shock assumption that Medicare is going to cover all health care expenses in retirement. The $285K also assumes the couple doesn’t have employer-sponsored retiree health care coverage and qualifies for “Original Medicare” (not Medicare Advantage, for example).
FierceHealthIT
APRIL 27, 2020
HHS is imploring a federal appeals court to reinstate a controversial 2014 rule that would handle overpayments to Medicare Advantage plans.
BHM Healthcare Solutions
MAY 1, 2018
Payers are rapidly becoming educated in telehealth and are keen on closing telehealth gap, but need to be mindful of Medicare requirements. Almost a third of telemedicine claims sampled by HHS’ Office of Inspector General did not meet Medicare requirements, resulting in an estimated $3.7
American Well
JUNE 25, 2017
the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. Sean Duffy (R-Wis.)
American Well
JUNE 25, 2017
the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. Sean Duffy (R-Wis.)
eVisit
JANUARY 28, 2020
In 2014, the Centers for Medicare and Medicaid (CMS) determined the total cost of all readmissions exceeded $26B and approximately 65% was attributed to preventable readmissions. High Readmission Rates Costs Your Organization Millions Each Year.
FierceHealthIT
MARCH 19, 2018
Recent research shows that capping payments for elective joint replacements could reduce annual Medicare spending by billions of dollars. In 2014, Medicare paid an average of $17,223 and $16,292, respectively, for hip and knee replacements. healthcare system would save $4.4 billion.
FierceHealthIT
NOVEMBER 16, 2018
The number of Medicare beneficiaries using telehealth services increased nearly 50% between 2014 and 2016, according to a new report released by CMS. The total number of members using telehealth is well under 1%, but analysts say even a small increase could lead to a huge increase in overall visits.
Medicine and Technology
NOVEMBER 11, 2014
It's the decision that many people have been waiting for: it appears that Medicare is proposing to cover low-dose CT scan for lung cancer screening for specific patients. The Medicare " Proposed Decision Memo for Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) (CAG-00439N) " came out on Nov 10, 2014.
FierceHealthIT
MARCH 13, 2018
Using government databases, the report found that 54% of doctors who wrote prescriptions to Medicare patients in 2014 and 2015 for opioids received a payment from pharmaceutical companies that make the drugs.
Healthcare IT Today
JULY 10, 2023
Company Adds Two Board Members and a Senior Executive to Lead its Medicare Advantage Business Aledade , the largest network of independent primary care practices in the country, today announced the closing of a $260 million Series F funding round to enhance and acquire services and technology to support its practices.
Healthcare IT News - Telehealth
SEPTEMBER 19, 2022
in 2014 and 45.5% Reforming Medicare payment. The study, published in Mayo Clinic Proceedings, found that the prevalence of burnout among U.S. physicians was 62.8% in 2021, compared with 38.2% in 2020, 43.9% in 2017, 54.4% The result is that one in five physicians intends to leave their current practice within two years.
Digital Health Wire
FEBRUARY 26, 2023
The company got its start as a Medicare-focused primary care practice in 2014, but has since vertically integrated to combine a risk-bearing entity with an in-home clinic model that supports other clinics with their transition to value-based care.
Health Populi
AUGUST 11, 2019
Five years ago, financial toxicity as a side-effect was noted by two Sloan Kettering Medical Center in a landmark report on 60 Minutes in October 2014. Health Populi’s Hot Points: In 2014, Dr. Bach and Dr. Saltz were referring to innovative therapeutics like Gleevec and Zaltrap, each priced then at over $10,000 a month.
Healthcare IT Today
APRIL 21, 2023
Series B funding proceeds will enable Scene to further accelerate its ability to serve Medicaid and Medicare managed care plans, pharmaceutical companies, and clinical research organizations. This financing brings the total investment in Scene to over $25 million since its founding in 2014.
Insulin Nation
NOVEMBER 30, 2016
According to the Centers for Medicaid and Medicare Services, the national health care expenditure, in total, for 2014 was $3 trillion, growing 5.3 percent of the 2014 gross domestic product (“GDP”). health care expenditure and one-third of Medicare expenditures, or $600 billion a year. Prescription drug spending grew 12.2
Healthcare IT News - Telehealth
DECEMBER 17, 2021
According to the indictment , starting in May 2014 the defendants and their co-conspirators allegedly used telehealth to generate prescriptions for compounded medications and durable medical equipment, regardless of medical necessity.
ACA Times
DECEMBER 1, 2015
in 2014, and overall health spending grew by 5.3%, according to the Centers for Medicare & Medicaid Services (CMS) , a slower rates of growth than most years prior to passage of the Affordable Care Act. in 2014, compared to 2.4% in 2014, compared to 2.4% in 2014, compared to 2.4% for Medicare.
Insulin Nation
DECEMBER 18, 2013
A state-of-the-art wound therapy that prevents amputations is under threat from proposed cuts in Medicare reimbursement rates, according to regenerative medicine experts. Apligraf, pictured here, is a dressing made of living cells used to help heal diabetic foot ulcers.
Aging in Place Technology Watch
OCTOBER 29, 2020
In 2019, Medicare Advantage began covering some non-skilled home care. And just this past week, HomeThrive announced an $18 million Series A round touting its tech-enablement, and Honor, with its tech expertise’ , announced another $140 million Series D investment, bringing its grand total to $255 million since 2014.
Health Populi
APRIL 16, 2018
Here’s a New York Times article from 2014 discussing the company’s vision for expanding primary care. Walmart is enhancing about 500 of 3500 stores, and health will be part of the interior redecorating. Walmart has had ambitious plans in healthcare since those $4 Rx’s were introduced. Just sayin’]).
ACA Times
APRIL 20, 2016
Since 2014, prescription drug costs have continued to rise, due in part to specialized medications for advancements in the treatment of various medical conditions. Below are bulleted figures from the KFF report: In 2014, prescription drug cost spending rose 11.4%, up almost 10% from the previous year. in 2014, 14.1%
Aging in Place Technology Watch
DECEMBER 12, 2018
Did you know that ‘social isolation’ has become a named baby boomer health condition spiking Medicare costs by an additional $134 per enrollee – tucked into the list that includes arthritis (+$117 of cost) and diabetes (+$270), source AARP? please note that the ineligible younger boomers are generally not costing Medicare any money.
InTouch Health
APRIL 30, 2020
billion in 2014 and grew at a compound annual growth rate of 18.4% from 2014 to 2020. Both Medicaid and Medicare now offer telehealth parity, which means virtual care services are reimbursed at the same rate as in-person services. The global telemedicine industry was valued at $17.8
Health Populi
OCTOBER 28, 2019
published by the National Bureau of Economic Research found a close link between electoral politics and Medicare: that is, between legislative processes in the U.S. Between 2007 and 2014, hospital prices grew 42%. A recent study on politics and health care spending in the U.S. Congress and healthcare spending.
ACA Times
MAY 1, 2019
Department of Health and Human Services’ Center for Medicare and Medicaid Services (CMS) has extended the period of non-enforcement for certain non-compliant health policies under the Affordable Care Act through the end of 2020. 2 minute read: The U.S.
BHM Healthcare Solutions
MARCH 19, 2019
Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Opioid use among Blue Shield of California members with noncancer pain fell 56 percent since 2014, the health insurer said March 18. .”
Xealth
JULY 20, 2023
Patient Outreach for Annual Wellness Visits Organization: Several healthcare provider organizations Business Goal: Improve patient outcomes and increase health system revenue Project: The Annual Wellness Visit (AWV) for Medicare is one of the most powerful, widely deployed value-based care tools available.
care innovations
APRIL 25, 2018
million in telehealth claims per year “did not meet Medicare requirements,” the Office of Inspector General (OIG) at the Department of Health & Human Services (HHS) has thrust new light upon America’s byzantine telemedicine reimbursement policies and the limitations they place on the expansion of value-based care.
Henry Kotula
FEBRUARY 28, 2021
In separate news, Optum, the services division of insurance giant UnitedHealth Group, was reported to have struck a deal to acquire Landmark Health, a fast-growing home care company whose services are aimed at Medicare Advantage-enrolled, frail elderly patients.
Hinduja Global Solutions
JULY 29, 2019
The objective is to develop and validate a predictive model for 15-month mortality using a random sample of community-dwelling Medicare beneficiaries. Data source The Centres for Medicare & Medicaid Services’ Limited Data Set files containing the five per cent samples for 2014 and 2015. million beneficiaries.
ACA Times
MARCH 15, 2017
The Center for Consumer Information & Insurance Oversight (CCIIO), under the Centers for Medicare & Medicaid Services (CMS), released a notice at the close of February, announcing that insurance companies may extend coverage of certain non-grandfathered individual and group plans that are currently not ACA compliant for another year.
GlobalMed
DECEMBER 9, 2020
Between 2004 and 2014, 179 rural counties lost hospital-based obstetric services ; by 2014, more than half of all rural counties lacked a hospital offering maternity care. According to the Centers for Medicaid & Medicare Services, 10 to 40 percent of women skip postpartum visits for these reasons.
E-CareManagement
DECEMBER 1, 2014
The editor and publisher of Accountable Care News have been generous in allowing me to republish my article from the November 2014 issue. The issue is being revisited in major 2014 MSSP reg revisions which are in process. Click here to download a.pdf copy of the article. It’s in-depth — about 2,000 words.
Health Populi
OCTOBER 24, 2022
I had asked some years ago, “what is a pharmacy” anymore, when CVS Pharmacy dropped tobacco from its SKUs and aisles in February 2014, rebranding as CVS Health; and, when Amazon purchased PillPack in June 2018. ” Dr. Cosgrove based that sobering forecast due to changes in the U.S.
Insulin Nation
JULY 15, 2016
According to a report in Kaiser Health News, parents of children with diabetes spent an average of $2,173 for out-of-pocket costs in 2014. The study examined trends in health care utilization and spending between 2012 and 2014. The data was collected from those aged 65 and younger who were covered by employer-sponsored insurance.
ACA Times
FEBRUARY 24, 2015
Many consumers who have not signed up for health insurance the Affordable Care Act will have another chance to do so, thanks to a special March 15-April 30 enrollment period announced by the Centers for Medicare Services (CMS) & Medicaid Services (CMS).
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