Remove Governance Remove Health Insurance Remove Medicaid Remove Overpayment
article thumbnail

Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Cathy Rodgers (R-Wash.)

Medicare 105
article thumbnail

Navigating the Intersection of Payment Integrity and Provider Relations in Healthcare

Innovaare Compliance

According to the National Health Care Anti-Fraud Association, the financial losses due to healthcare fraud are estimated to be in the billions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1 billion in healthcare fraud judgments and settlements.

Fraud 52
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

What Are THE 3 Major Things Addressed in the HIPAA Law?

HIPAA Journal

For example: Had the health insurance industry been allowed to continue operating as it did prior to HIPAA, tens of millions of Americans would be excluded from health plan benefits. Had the momentum to improve health care not been given a kickstart by HIPAA, subsequent health care initiatives may never have happened.

HIPAA 119
article thumbnail

Introduction to Telebehavioral Health

AIHC

Medicare covers many telebehavioral and telemental health services including audio-only services. 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.

article thumbnail

Retrieving Billions in Overpayments by CMS

Healthcare IT Today

government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. How can such overpayments be uncovered? public in overpayments. They expect to recoup 4.7 billion dollars through this program.

article thumbnail

Supreme Court Rules Against HHS in Hospital Medicare Reimbursement Case

The Health Law Firm Blog

Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. By George F. Indest III, J.D., This came in a ruling that limits regulators’ power to control what the program pays for certain [.]

article thumbnail

Health Provider News

Hall Render

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M in 256-Slice CT scanner Lifepoint reports $200M+ economic impact in Cen Ky St.