Natalia Mazina
JULY 3, 2022
For technical and financial reasons, the DHCS has not implemented the new reimbursement methodology until 2019. This lead to overpayments to pharmacies. Only in 2020, it started sending notices of recoupment to pharmacies specifying the amounts owed.
Healthcare Compliance Blog
JUNE 9, 2022
Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare. Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate. He is awaiting sentencing on those charges.
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Kaiser Health News
JUNE 29, 2022
They also called for the Centers for Medicare & Medicaid Services, or CMS, to revive a foundering audit program that is more than a decade behind in recouping billions in suspected overpayments to the health plans, which are run mostly by private insurance companies.
Innovaare Compliance
MARCH 1, 2022
1] The Centers for Medicare & Medicaid Services (CMS) has to establish an annual Part B premium that will adequately fund projected Medicare spending and maintain an adequate reserve in case actual costs are higher than estimated. 6] Improper payments can be overpayments and underpayments. in 2021 to $170.00
Health Care Law Brief
APRIL 3, 2023
On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). See Report to Congress: Risk Adjustment in Medicare Advantage (Dec. See 88 Fed. 6643 (Feb.
AIHC
SEPTEMBER 5, 2023
Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 (COVID-19) pandemic. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.
Innovaare Compliance
JUNE 28, 2022
The Centers for Medicare & Medicaid Services (CMS) launched a new cycle of CMS program audits in February 2022. This causes claims to providers to be paid incorrectly, which results in enrollees being overcharged for their coinsurance or delayed refund of overpayments. .
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