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Medicare Corrects Readmissions Penalties for 1,246 Hospitals — Are You on the...

By Jordan Rau, Kaiser Health News Staff Writer In its effort to crack down on repeat hospitalizations, Medicare has its own readmission: for the second time in six months, it has erred in calculating...

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Supreme Court Passes on Appeal for Medicare for Psychiatric Hospitals

Even though lower courts have split opinions in three other cases, the U.S. Supreme Court declined to settle the issue on whether the federal government had underpaid states for treating patients in...

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Game Show Executive Believes He Has the Answer to Healthcare Financial Crisis

Can the man who brings reruns of “Family Feud” and “The Newlywed Game” into our living rooms fix our healthcare crisis? David Goldhill, president of the Game Show Network, has spent the winter...

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Will Education Stop Physicians from ‘Gaming’ the Medicare System?

Waste in national healthcare spending can be reduced if physicians received more education about “program integrity,” argue officials from the Centers for Medicare and Medicaid Services (CMS) and U.S....

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Accountable Care Orgs and Other Medicare Innovations Come Under Congress’s...

Accountable care organizations and other “experiments” designed to reduce the cost of healthcare are drawing fire from Congress’s Republicans, Politico reports, who attacked the main proponent of those...

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New Rounds of Healthcare Provider Layoffs — Is Sequestration Responsible?

Hospitals and other healthcare providers around the nation are announcing significant layoffs, but the reasons behind them appear to be far more than just sequestration cuts of Medicare or programs...

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Free Preventative Care Services Now Cover 71 Million, Feds Report

An estimated 71 million Americans became fully covered for preventative care such as colonoscopy screening, Pap smears, mammograms, well-child visits, flu shots, and many other services since the...

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Actuaries Foresee Double-Digit Insurance Increase, Modest Boost in Spending...

A newly released study from the Society of Actuaries is receiving national media attention for its findings that Americans will see double-digit increases for health insurance premiums thanks to the...

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Cutting Medicare Only Transfers Costs onto Providers, HHS Secretary Sebelius...

Cutting Medicare will “shift the costs” to the private sector, U.S. Department of Health and Human Services Secretary Kathleen Sebelius told reporters yesterday in a White House briefing. Nor will...

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Are Surety Bonds the Next Weapon to Fight Medicare Fraud and Abuse?

Medicare is overpaying tens of millions of dollars each year to durable medical equipment suppliers, and a group of U.S. senators are looking at surety bonds as the way to get that money back in the...

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Feds Approve New Test to Cut Costs for Dual Eligibles

California has become the latest state to win approval for a demonstration of coordinated care for dual eligibles, the state Health and Human Services Agency announced last week. For the next three...

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Healthcare Reform Turns Three, But Major Impacts Yet to Be Felt

(Editor’s note: The following article first appeared in the DECA Blog, a service of DECA Financial Services  By Evan J. Albright The Patient Protection and Affordable Care Act turned three years old...

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Hospitals in 2012 Increased RAC Appeals, Overturned More Denials

Centers for Medicare & Medicaid Services (CMS) Recovery audit contractors (RACs) are denying more claims than ever and issuing documentation requests at a record pace. But at the same time,...

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Sequestration Medicare Cuts Take Full Effect, But Greater Revenue Cycle Risk...

Yesterday the Centers for Medicare and Medicaid (CMS) instituted the across-the-board 2 percent cut in Medicare reimbursements for fee-for-service claims, but a greater threat to the revenue cycle is...

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Battle Lines Drawn between Hospitals, Medicare Auditing Contractors

Medicare’s Recovery Audit Contractors (RACs) are warning that if the Medicare Audit Improvement Act is passed, fraud and waste will be allowed to run rampant. Last month Rep. Sam Graves (R-Mo.) and...

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Medical Denials Management for a New Age

Editor’s Note: This article is the second in a two-part series by Shanna Rogers. The first installment was published yesterday on insidePatientFinance.com. Click here to read it. Get ready: Claims...

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Oncology Providers Seek Exemption from Sequester Cuts to Medicare

Cancer treatment providers have broken ranks with other healthcare providers and have launched a campaign to exempt cancer-fighting drugs from Medicare sequestration cuts. The spin on the story,...

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Obama Will Propose Medicare Cuts Wednesday

President Barack Obama’s administration announced that on Wednesday it will submit a budget that will include Medicare cuts, but did not release exactly how the cuts will be made and how much they will...

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Opinion: Medicare Reimbursement Scramble Means We’re Already Divided and...

More cuts to Medicare reimbursements are coming, and it appears to be every man for himself (and woman for herself) over what’s left. Healthcare zombies, just like the upcoming movie “World War Z,”...

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Medicaid Expansion under Obamacare Now Official

As promised under the Patient Protection and Affordable Care Act (ACA), the U.S. Department of Health and Human Services last week made official that the federal government will pay 100 percent of...

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