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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

Notable Omissions from Proposed Rule CMS declined to adopt previously proposed amendments to the standard for “identified overpayments” under Medicare Parts A, B, C, and D. The Social Security Act requires “a person” who has received an overpayment to report and return the overpayment no later than 60 days after being “identified.”

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2018 Medicare Fee-For-Service improper payment rate is lowest since 2010

CMS.gov

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:46. Seema Verma. Fraud, waste, & abuse.

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Medicare Audit Claims University of Miami Hospital Owes Government $3.7 Million

The Health Law Firm

This is according to an audit report of the hospital’s billing practices that found the hospital allegedly overbilled the health care program in 2009 and 2010. Indest III, J.D., Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7

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Medicare Compliance Review of West Florida Hospital in Pensacola

The Health Law Firm

However, the overpayments for the years 2009 and 2010 totaled up to $173,000. According to the audit, the hospital complied with Medicare billing requirements for the documentation majority of inpatient and outpatient claims. Official Break Down of the Audit.

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ChristianaCare Settlement Drives New Legal Theory in False Claims Act Litigation: Hospitals Take Note When Providing Clinical Services to Their Private Physician Groups

Healthcare Law Blog

In response, ChristianaCare argued that Sherman himself was responsible for reporting any violations of the Anti-Kickback Statue or Stark Law to the OIG and he did not do so, instead certifying compliance with the CIA.

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Tennessee Ambulance Company Settles Lawsuit Over A $2 Million Bill

The Health Law Firm

Back in March of 2010, the Nashville ambulance company sued the DHHS after being sent a $2.65 million overpayment demand, according to the Nashville Business Journal. To see the Nashville Business Journal article on the lawsuit, click here. Mammoth Fine Came from Error Rate Extrapolation Formula.