2024 report shows skilled nursing improper payments at 17.2%, double Medicare average. Strong compliance and thorough documentation crucial to avoid audits and fraud allegations.

Congressional hearing explores policies to enhance Medicare coverage and transparency for breakthrough medical technologies, aiming to improve senior access and healthcare outcomes.

OIG finds nursing homes underreporting major injury falls affecting accuracy of CMS Care Compare data; CMS to enhance compliance and reporting measures.

Explore financial assistance programs like Medicare Savings Program and Extra Help that help Medicare beneficiaries manage out-of-pocket healthcare costs and prescription drug expenses.

Medicare audits are becoming more frequent and aggressive, leading to inflated repayment demands. Learn how statistical challenges, independent coding reviews, and specialty expertise can protect healthcare providers from exaggerated audit outcomes.

The U.S. House advances legislation ensuring Medicare coverage for FDA-authorized breakthrough medical technologies, boosting patient access and streamlining approval processes.

Medicare covers short-term skilled nursing care but excludes long-term custodial care in nursing homes. Insurance professionals must understand coverage nuances, eligibility, and alternative financing options including Medicaid and long-term care insurance.

The AHA backs legislation to extend Medicare waivers for hospital-at-home programs, aiming to improve care quality and cost efficiency under new healthcare bills reviewed by Congress.

Rhode Island's health insurance marketplace faces sharp premium increases and enrollment declines after expiration of federal Enhanced Premium Tax Credits. State officials urge congressional action to restore subsidies and maintain affordable coverage.

Two South Florida men indicted for a $34.8 million Medicare fraud involving medically unnecessary durable medical equipment and illegal kickbacks. Highlights compliance and regulatory risks in Medicare billing.