OIG Report Reveals Underreporting of Major Injury Falls in Medicare Nursing Homes
OIG finds nursing homes underreporting major injury falls affecting accuracy of CMS Care Compare data; CMS to enhance compliance and reporting measures.
Financial Assistance Programs to Support Medicare Beneficiaries in Managing Costs
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 Intensify: Strategic Defense with Statistical and Clinical Expertise
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.
Medicare Breakthrough Medtech Coverage Advances with Congressional Backing
The U.S. House advances legislation ensuring Medicare coverage for FDA-authorized breakthrough medical technologies, boosting patient access and streamlining approval processes.
Medicare Limits Nursing Home Coverage: What Insurance Pros Need to Know
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.
AHA Supports Extension of Medicare Waivers for Hospital-at-Home Program
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.
Two South Florida Men Indicted in $34.8M Medicare Durable Medical Equipment Fraud Scheme
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.
Key Developments in U.S. Prior Authorization Reform Legislation and CMS Initiatives
Explore recent legislative and CMS efforts to reform prior authorization in U.S. healthcare, focusing on bipartisan bill progress, CMS regulations, and new experimental models to streamline Medicare prior authorization processes.
Senators Reintroduce Bill to Expand Medicare Coverage for Pharmacist Services in Underserved Areas
Bipartisan bill reintroduced to authorize Medicare payments for pharmacists providing basic medical services in underserved and rural areas, enhancing healthcare access for seniors.
CMS Launches $50B Rural Health Transformation Program with Nov. 5 Deadline
CMS invites states to apply for the $50B Rural Health Transformation program aimed at improving rural health outcomes, with a Nov. 5 deadline and specific funding rules.