Tag : medicare

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Baton Rouge Doctor and His Medical Billing Supervisor Plead Guilty to Fraudulent Billing Scheme

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(AGENPARL) – Washington (DC ), gio 14 febbraio 2019 A Baton Rouge, Louisiana-based doctor pleaded guilty yesterday and his medical billing supervisor pleaded guilty today for their roles in a scheme to defraud Medicare and other health care insurers.   Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal...
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HHS launches innovative payment model with new treatment and transport options to more appropriately and effectively meet beneficiaries’ emergency needs

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(AGENPARL) – Washington (D.C.), gio 14 febbraio 2019 Today, the U.S. Department of Health and Human Services (HHS), Center for Medicare and Medicaid Innovation (Innovation Center), which tests innovative payment and service delivery models to lower costs and improve the quality of care, announced a new payment model for emergency...
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Home Health, Hospice & Durable Medical Equipment Open Door Forum

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(AGENPARL) – Bethesda (Maryland), mar 12 febbraio 2019 Overview: The Home Health, Hospice & Durable Medical Equipment Open Door Forum (ODF) addresses the concerns of three unique health care areas within the Medicare & Medicaid programs. Issues related to Home Health PPS, the newly proposed competitive bidding for DME and the...
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Slow Growth in Medicare and Medicaid Spending Per Enrollee Has Implications for Policy Debates

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(AGENPARL) – Bethesda (Maryland), mar 12 febbraio 2019 Medicare and Medicaid contain per enrollee health spending growth better than private insurance. The Issue Since 2006, national health expenditure (NHE) growth has been slow relative to historic growth rates. Annual spending growth between 2006 and 2017 averaged 5.2 percent for Medicare,...
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Targeting High-Need Beneficiaries in Medicare Advantage: Opportunities to Address Medical and Social Needs

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(AGENPARL) – Bethesda (Maryland), lun 11 febbraio 2019 Notes 1. Karen E. Joynt et al., “Contribution of Preventable Acute Care Spending to Total Spending for High-Cost Medicare Patients,” Journal of the American Medical Association 309, no. 24 (June 26, 2013): 2572–78; and Susan L. Hayes et al., High-Need, High-Cost Patients:...
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Genetic Testing Company Agrees to Pay $1.99 Million to Resolve Allegations of False Claims to Medicare for Medically Unnecessary Tests

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(AGENPARL) – Washington (D.C.), lun 11 febbraio 2019 “The Department of Justice is committed to ensuring that Medicare reimburses costs for laboratory testing that are reasonable and necessary for the individual patient,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division.  “Medically unnecessary and unproven testing...
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Medicare Paid Twice for Ambulance Services Subject to Skilled Nursing Facility Consolidated Billing Requirements

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(AGENPARL) – Washington (DC), lun 11 febbraio 2019 | Audit (A-) | Complete Report | Report in Brief Prior OIG reviews identified significant Medicare Part B overpayments, including those to ambulance suppliers, for services they provided to Medicare beneficiaries during skilled nursing facility (SNF) stays covered under Medicare Part A....
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2020 Medicare Advantage and Part D Advance Notice Part II and Draft Call Letter

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(AGENPARL) – Bethesda (Maryland), gio 31 gennaio 2019 2020 Medicare Advantage and Part D Advance Notice Part II and Draft Call LetterFact Sheet On January 30, 2019, the Centers for Medicare & Medicaid Services (CMS) released Part II of the 2020 Advance Notice of Methodological Changes for Medicare Advantage (MA)...
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California Doctor Sentenced to Prison for Role in Medicare Kickback Conspiracy

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(AGENPARL) – Washington (D.C.), mer 30 gennaio 2019 A California doctor was sentenced to 42 months in prison on Jan. 22 for his role in a Medicare kickback conspiracy involving a Los Angeles-area home health agency. Fonte/Source: https://www.justice.gov/opa/pr/california-doctor-sentenced-prison-role-medicare-kickback-conspiracy

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