During his confirmation hearing in January, Secretary of Health and Human Services (HHS) Tom Price said that the Centers for Medicare & Medicaid Services (CMS) should spend less time focusing on medical necessity verification and more time rooting out true fraud and abuse.
The Government Accountability Office (GAO) in February released a report outlining the need for the Department of Health and Human Services (HHS) to improve its planning and evaluate its efforts to increase information exchange via electronic health records (EHRs) in the post-acute care setting.
The California Department of Health Care Services has fined Kaiser Permanente $2.5 million for failing to divulge data on patient care required by the state’s Medicaid program, according to a report from Kaiser Health News (KHN).
A review of Medicare Advantage online provider directories revealed that 45% of listed provider locations are inaccurate, according to a recent report from the Centers for Medicare & Medicaid Services (CMS).
A federal judge blocked a final rule promulgated by the Centers for Medicare & Medicaid Services (CMS) that would have prevented patients with end-stage renal disease (ESRD) from receiving charitable contributions to pay for private health coverage.
The Centers for Medicare & Medicaid Services (CMS) is doling out more penalties for 769 hospitals whose patients experience a high number of hospital-acquired conditions (HACs), Kaiser Health News reported
CMS in December finalized the new mandatory bundled payment models for cardiac and orthopedic care. As part of its effort to shift Medicare payments to rewarding quality by encouraging the coordination of care between hospitals, physicians and other providers, CMS announced the following three policies:
The Department of Justice (DOJ) recovered more than $4.7 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2016. This is the third highest annual recovery in False Claims Act history, bringing the fiscal year average to nearly $4 billion since 2009, and the total recovery during that period to $31.3 billion.