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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.

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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.

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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.

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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 [.]

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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.,

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Health Provider News

Hall Render

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Acquisition of BCBSLA Paused a Second Time It was the biggest health care deal in Louisiana history. What they say sets them apart.

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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.