Here are nine issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.
1. Three physicians and health policy directors with Physicians for a National Health Program conducted a study on how Medicare pays private insurers, also known as Medicare Advantage plans, and they identified overpayments totaling $282.6 billion since 1985.
2. An audit by HHS' Office of Inspector General found that CMS failed to meet federal notification requirements and did not offer adequate help to affected individuals when its Medicare patient database was breached.
3. Little is known about the procedures of the relatively young Medicaid Recovery Auditors, also known as Medicaid RACs, but as those groups begin to conduct more audits, hospitals and other providers will soon gain an idea of what revenue cycle areas the RACs will target.
4. In states that publicly report percutaneous coronary intervention outcomes, Medicare beneficiaries with acute myocardial infarction were less likely to undergo PCI compared with states that did not publicly report this data.
5. The American College of Emergency Physicians announced studies show frequent users of the emergency department do not have higher rates of non-urgent visits compared with typical ED patients. Studies showed that frequent ED users are more likely to be on Medicare or Medicaid and to have psychiatric illnesses.
6. Tracy Brewer, lead project manager of Albuquerque, N.M.-based Presbyterian Healthcare Services' Medicare Pioneer Accountable Care Organization, reviewed the entity's first year as one of the premier ACOs.
7. The Medicare Payment Advisory Commission held its most recent meeting last week, and it had four major items on its agenda.
8. More than 25 hospitals in Arkansas received bonus payments from the state's Medicaid program for improving birth outcomes and quality care.
9. In the third quarter of the 2012 federal fiscal year, Medicare Recovery Auditors (RACs) collected $657.2 million in overpayments — the highest total of any quarter since October 2009.
1. Three physicians and health policy directors with Physicians for a National Health Program conducted a study on how Medicare pays private insurers, also known as Medicare Advantage plans, and they identified overpayments totaling $282.6 billion since 1985.
2. An audit by HHS' Office of Inspector General found that CMS failed to meet federal notification requirements and did not offer adequate help to affected individuals when its Medicare patient database was breached.
3. Little is known about the procedures of the relatively young Medicaid Recovery Auditors, also known as Medicaid RACs, but as those groups begin to conduct more audits, hospitals and other providers will soon gain an idea of what revenue cycle areas the RACs will target.
4. In states that publicly report percutaneous coronary intervention outcomes, Medicare beneficiaries with acute myocardial infarction were less likely to undergo PCI compared with states that did not publicly report this data.
5. The American College of Emergency Physicians announced studies show frequent users of the emergency department do not have higher rates of non-urgent visits compared with typical ED patients. Studies showed that frequent ED users are more likely to be on Medicare or Medicaid and to have psychiatric illnesses.
6. Tracy Brewer, lead project manager of Albuquerque, N.M.-based Presbyterian Healthcare Services' Medicare Pioneer Accountable Care Organization, reviewed the entity's first year as one of the premier ACOs.
7. The Medicare Payment Advisory Commission held its most recent meeting last week, and it had four major items on its agenda.
8. More than 25 hospitals in Arkansas received bonus payments from the state's Medicaid program for improving birth outcomes and quality care.
9. In the third quarter of the 2012 federal fiscal year, Medicare Recovery Auditors (RACs) collected $657.2 million in overpayments — the highest total of any quarter since October 2009.
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