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AHA and Partners Urge CMS to Shield ACOs and MIPS Clinicians From Skin Substitute Billing Risks
AHA and coalition urge CMS to adjust Medicare programs to prevent financial penalties on ACOs and MIPS clinicians for increased skin substitute billing linked to inefficiency and fraud.
Medicare Hospital Star Ratings Show Challenges for Quad Cities Providers
Medicare star ratings reveal performance challenges for Quad Cities hospitals, with low sepsis care scores and high ER wait times prompting quality improvement initiatives.
Medicare Diagnostic Lab Fraud Nets Two-Year Sentence and $1.17M Restitution
Mohammed Asif sentenced to two years for orchestrating over $1.17 million Medicare fraud through a Washington-based diagnostic lab, highlighting enforcement of healthcare billing compliance.
Medicare Open Enrollment: Comparing Supplemental and Advantage Plans
Medicare Open Enrollment runs until Dec. 7, allowing beneficiaries to choose between Supplemental plans and Medicare Advantage plans that enhance Original Medicare coverage including prescription drug options.
Year-End Medicare Coverage Review and Enrollment Insights for Beneficiaries
Explore key Medicare year-end actions including coverage review, Open Enrollment details, preventive benefits utilization, and fraud awareness to optimize 2024 Medicare plans.
Jamestown, NY Secures $1.3M State Reimbursement for Retiree Medicare Transition
Jamestown, NY, secured a $1.3 million reimbursement from New York State for transitioning city retirees to Medicare supplement plans, impacting municipal healthcare budgeting and retirement benefits management.
Medicare Part B Premiums and Deductibles Rise in 2026
Medicare Part B premiums and deductibles increase in 2026, impacting retirees and Social Security benefits. Learn about IRMAAs and Part D premium adjustments.
KFF Analysis Highlights Medicare Advantage Diagnosis Additions Impacting CMS Payments
KFF analysis of 2022 Medicare Advantage data shows 17% had diagnosis additions increasing CMS payments, with minimal diagnosis deletions impacting risk adjustments.
Addressing Payer Denials and Utilization Challenges in US Healthcare
Explore challenges healthcare providers face with payer denials and audits and how solutions like PayerWatch's platform improve revenue protection and utilization management.