Rodney L. Yentzer sentenced to 42 months for defrauding Medicare and Medicaid through unnecessary urine drug tests, resulting in multi-million dollar restitution. Case underscores insurance fraud risks in healthcare diagnostic billing.
Proposed federal cuts to Medicaid and Medicare threaten the financial sustainability of rural hospitals like Monadnock Community Hospital, impacting care delivery and staffing. Explore strategic responses and implications for healthcare reimbursement and compliance.
Explore CMS's FY 2026 proposed Medicare IPPS rule detailing hospital payment increases, uncompensated care funding, quality program updates, and regulatory streamlining affecting hospital reimbursement and compliance for 2025-26.
Understand Medicare enrollment requirements for self-employed individuals with individual health plans to avoid Part B penalties and coverage gaps. Learn key distinctions from group employer plans and enrollment deadlines.
Explore the impact of Medicare Administrative Contractors on coverage decisions for advanced wound care therapies and the potential of AI-driven reforms to improve patient access and reduce costs.
Medicare does not recognize individual health plans as qualifying employer coverage for delaying Part B enrollment. Self-employed individuals must enroll timely to avoid penalties.
CMS's 2026 Final Rule implements the Medicare Drug Price Negotiation Program with the Medicare Transaction Facilitator, affecting Part D drug pricing and pharmacy reimbursement processes.
Congressional budget cuts proposed by House Republicans raise concerns about potential impacts on Medicare, Medicaid, and Veterans Affairs funding. Key debates focus on program efficiency versus benefit reductions.
Dr. Mehmet Oz confirmed as CMS Administrator with mandate to protect and grow Medicare Advantage, improving care and reducing costs for seniors.
Study reveals shifting patterns in home health care use among Medicare Advantage enrollees, highlighting implications for care quality, equity, and policy in U.S. Medicare programs.
