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Retrieving Billions in Overpayments by CMS

Healthcare IT Today

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.

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Medicare Advantage 2024 Rate Announcement – Further Impacts to Risk Adjustment

Health Care Law Brief

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 ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

While the nation seeks to reopen and put COVID-19 behind us, providers are still addressing new variants and recovering from the financial and emotional impact of the pandemic. If Medicare coverage requirements for telehealth services (e.g., If Medicare coverage requirements for telehealth services (e.g.,

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Preventing Genetic Testing Fraud: 5 Actions for Health Plans

Healthcare IT Today

The following is a guest article by Erin Rutzler, Vice President of Fraud, Waste, and Abuse at Cotiviti In Delaware, more than 250 Medicare patients underwent unnecessary genetic testing based on telehealth consultations that often lasted less than two minutes— costing Medicare thousands of dollars per patient.

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Health Care Real Estate Briefing: HHS Extends Public Health Emergency | SNF Staffing Shortages Still on the Rise | Record Amount of Real Estate to Hit the Market This Year

Hall Render

In other news, the number of new COVID-19 cases in SNFs is down significantly, although staffing shortages continue to be one of the top issues facing SNFs and other health care providers. Furthermore, COVID-19 is having a major impact on return to work. CMS plans to increase Medicare reimbursement for SNFs by 3.9%

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Introduction to Telebehavioral Health

AIHC

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 (COVID-19) pandemic.

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Why Medicaid Programs Need to Update Their Information Systems

HIT Consultant

You don’t have to be a news junkie or political aficionado to know that state unemployment information systems massively failed during the COVID-19 pandemic at a time when they were most desperately needed. In Ohio, unemployment overpayments reached $3.86 Centers for Medicare and Medicaid Services (CMS) reimbursed states $34.3