A medical care group part of dialysis giant DaVita Inc. will pay $270 million to resolve claims it provided inaccurate information that caused Medicare Advantage plans to receive inflated Medicare payments.
Category: FierceHealthPayer
CMS touts new Medicare plan tools as part of its focus on digitization
The agency says new online tools can help beneficiaries across the country choose the plan that’s best for them, though they may not reach all seniors.
GAO: These are the rural hospitals most likely to close
The federal watchdog agency raised new concerns about the rate of rural hospital closures in the U.S. last week. Here’s a look at which hospitals appear most at risk.
ACAP: Safety-net plans are ‘key innovators’ in coordinating substance abuse care
Coordinating care for patients with substance use disorder can be a challenge, according to a new analysis of safety net health plans. But some have found success by focusing on workforce training and patient engagement.
Federal watchdog suggests increased oversight for VA’s pharmacy inventory management
The Government Accountability Office recommended the Department of Veterans Affairs Medical Centers’ pharmacy inventories could benefit from a little more oversight after years of challenges—including difficulties with accurately accounting for and upd…
Medicare Advantage insurers routinely issue improper payment denials, OIG finds
The HHS Office of Inspector General recommended that CMS become significantly more involved in overseeing Medicare Advantage organizations (MAOs) following a recent report. OIG found that MAOs routinely deny payment for services that should have been p…
Rural states have the most to gain with Medicaid expansion, study suggests
Expansion and non-expansion states saw a sizable difference in coverage gains post-ACA, and the expansion states that improved the most contain large rural populations. Will rural states that haven’t expanded follow their example?
Community Health Systems-owned hospital chain agrees to pay $262M settlement for kickback, fraud allegations
A health system that is part of hospital giant Community Health Systems Inc. agreed to pay more than $262 million to resolve criminal charges and civil claims, the Justice Department announced on Tuesday.
Experts say antifraud laws are holding back rural health
Two longstanding laws designed to limit fraud are becoming problematic for rural health providers, experts told lawmakers during a Senate subcommittee hearing on Tuesday. Changes could ease digital health adoption and help with physician recruitment.
AHA: CMS’ site-neutral payment plan could lead to access problems as hospitals cut services
Hospital groups are warning that CMS’ plan to institute site-neutral payments could lead to access problems and cancelled services—and the change may not be within their authority to make, anyway.
