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Retrieving Billions in Overpayments by CMS

Healthcare IT Today

Challenges of Investigating Overpayments Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). How can such overpayments be uncovered? public in overpayments. But the needles pile up fast.

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What If Costco Designed the Prescription Drugs Sales Model?

Health Populi

Consumers Overpay for Generic Drugs , a new paper from the Leonard Schaeffer Center for Health Policy & Economics asserts, with recommendations to address the intermediaries who benefit from the way Americans currently pay for medicines. The good news about prescription drugs, in the context of medical spending in the U.S.,

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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.

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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

Kaiser Health News

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. Cathy Rodgers (R-Wash.)

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18 Former NBA Players Indicted For Alleged $4 Million Health Care Fraud Scheme

The Health Law Firm Blog

Board Certified by The Florida Bar in Health Law On October 7, 2021, 18 former NBA players were charged in New York federal court for an alleged health insurance fraud scheme to rip off the league's benefit plan, according to an indictment filed in the Southern District [.] Indest III, J.D.,

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Anomaly Secures $17M to Expand Precision Payment Platform to Improve Payment Accuracy

HIT Consultant

Overpayments, billing errors, and the resulting administrative rework creates completely unnecessary conflict and adds costs to the healthcare system that ultimately the consumer is responsible for paying.

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Introduction to Telebehavioral Health


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. Not all forms of technology are recognized as services which can be reimbursed by health insurance.