Medicare Update

Medicare Update

Medicare Compliance, Reimbursement & Enforcement Resource

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Written by mapolskis on
The  Centers for Medicare & Medicaid Services (CMS) intends to implement the permanent Medicare  Recovery Audit Contractor (RAC) program in phases beginning in March 2009.  Medicare providers should become informed about the RAC program and prepare for its implementation.  In this post, aspects of the nationwide RAC program are highlighted to assist Medicare providers in understanding the program. Background The Medicare Prescription Drug, Improvement and Modernization Act of 2003 directed the Department of Health and Human Services (HHS) to conduct a 3-year demonstration project using RACs.  The purpose of the demonstration was to determine whether RACs would be a cost-effective means of identifying Medicare ... Read Full Story
 
Written by mapolskis on
On February 20, 2009, the Centers for Medicare & Medicaid Services (CMS) posted 3 new  Frequently Asked Questions (FAQs) on the Medicare  Recovery Audit Contractor (RAC) Program .  One of the FAQs provides the name and contact information for each RAC. The other FAQs address whether there will be a RAC "blackout" period under certain MAC contract awards. As reflected on the CMS website, the 3 new FAQs are as follows: Feedback What is the name and contact information for each Recovery Audit Contractor (RAC)? Answer Region A: Diversified Collection Services, Inc. 1-866-201-0585 Region B: CGI 1-877-316-RACB (7222), e-mail address: racb@cgi.com Region C: Connolly ... Read Full Story
 
Written by mapolskis on
On February 6, 2009, the Centers for Medicare & Medicaid Services (CMS) announced that the bid protests to the permanent Medicare recovery audit contractor (RAC) program have been settled. According to CMS, the 4 RACs selected for the permanent RAC program will contract with subcontractors.  Interestingly, CMS reports that PRG Schultz, USA, Inc. will serve as a subcontractor to HealthDataInsights, Inc. , Diversified Collection Services, Inc. and CGI Technologies and Solutions, Inc. in RAC regions A, B and D.  CMS also reports that Viant Payment Systems, Inc. will serve as a subcontractor to Connolly Consulting Associates, Inc. in RAC region C. Apparently, each subcontractor ... Read Full Story
 
Written by mapolskis on
On February 26, 2009, President Obama presented Congress with a  fiscal year 2010 budget summary .  Among other things, the budget establishes a "reserve fund" of $633.8 billion over 10 years (2010-2019) to help finance health care reform. According to the budget documents, $317.8 billion of the $633.8 billion would be funded by new revenue resulting from certain federal tax changes.  However, the other half (or $316 billion) of the reserve fund would be derived from savings proposals aimed at promoting efficiency and accountability, aligning incentives toward quality, and encouraging shared responsibility.  With respect to the Medicare program, the proposals and related savings for ... Read Full Story
 
Written by mapolskis on
On March 5, 2009, President Obama will hold a White House Forum on Health Reform.  The Forum will involve approximately 150 attendees including members of Congress and representatives from various health care stakeholder groups (such as labor, business, providers, insurers and grassroots organizations).  During the Forum, attendees will be asked to offer ideas including ideas on how to bring down health care costs and increase coverage for all Americans. It has been reported that the Forum is the first step in the Obama Administration's strategy to enact comprehensive health care reform.  It also appears that the Forum, which includes diverse and bi-partisan stakeholders, serves ... Read Full Story
 
Southern Illinois University researchers determined Medicare beneficiaries living in rural areas were 27% more likely than urban recipients to have total knee or hip replacement surgeries. Researchers found women were more likely than men to undergo total joint replacement surgeries.  
From scienceblog.com ()
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Becomes an issue in health care reform debate WASHINGTON The nation's leaders are looking to South Florida, a cauldron of swindles by and against the elderly, for lessons on how to stem Medicare fraud to help pay for a health care overhaul.  
From feedburner.com ()
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Red Carpet to have free seminar Area residents having trouble choosing a Medicare part D plan are invited to the Red Carpet Health Care Center on Dec. 10 at 6 p.m. for a free seminar on Medicare prescription drug plans and to find out what plan may best  
From daily-jeff.com ()
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Tom Scully talked about how Medicare Part D operates, who is eligible for it, and the impact that health care legislation may have on it. Length: 44 min.Published: Today at 8:18am (ET)  
From c-span.org ()
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Medicare Paid Over $92 Million in Incentives for 2008 Under the Physician Quality Reporting Initiative Source: Centers for Medicare & Medicaid Services (HHS) More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, the Centers [...]  
From docuticker.com ()
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GAO found "pervasive deficiencies" in contract management by metro-Baltimore's own Centers for Medicare and Medicaid Services, which run the giant federal health programs. The Government Accountability Office concluded: "The continuing weaknesses in contracting activities and limited progress in addressing known...  
From weblogs.baltimoresun.com ()
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Efforts to crack down on Medicare fraud heat up while some experts say more should be done. Reuters reports that the "The Justice Department and Department of Health and Human Services launched a special strike force in Miami in 2007 to combat Medicare fraud in South Florida and similar units have been set up in Los Angeles, Houston and Detroit.  
From medicalnewstoday.com ()
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