WASHINGTON (AP) — How is it that a few doctors take in millions of dollars from Medicare?
Explanations for Wednesday’s eye-popping numbers from Medicare’s massive claims database ranged from straightforward to what the government considers suspicious, as the medical world confronted a new era of scrutiny.
The long-sought release of Medicare data revealed just how much the program paid individual doctors in 2012. An analysis by The Associated Press found that a tiny group, 344 out of more than 825,000 doctors, received $3 million or more apiece — a threshold that raises eyebrows for the government’s own investigators. Overall, about 2 percent of clinicians accounted for one-fourth of payments.
WASHINGTON – Industry stakeholders caution HME providers against putting too much stock in CMS’s announcement last week that it will not initiate new audits as it transitions to new recovery audit contractors (RACs).
“Essentially, this is common that a contractor slows down their new workload so they can finish it out before their contract ends,” said Wayne van Halem, president of The van Halem Group. “So, unfortunately for the DMEPOS industry, I believe it’s just the calm before the next storm.”
WASHINGTON — It’s hard to discern in the budget deal announced Tuesday night, but the bulk of its deficit savings come from fresh cuts to Medicare providers.
Under the proposal announced by Rep. Paul Ryan (R-Wis.) and Sen. Patty Murray (D-Wash.), chairs of their chambers’ respective budget committees, lawmakers will replace about two-thirds of the hated automatic cuts under budget sequestration (totaling $63 billion) for this year and next, and cut the deficit by about $23 billion.
Medical Practice Compliance Alert - Nov 2013
Can providers keep their businesses and industry on the rails?
- By David Kopf
- Oct 01, 2013
Ever since the Centers for Medicare and Medicaid Services began testing its competitive bidding program, providers have been on a roller coaster trying to stop the program. They’ve seen some bright points, such as the delay through the Medicare Improvements for Patients and Providers Act, but they’ve seen even more terrifying plummets, such as the Round One implementation, and now the even more precipitous Round Two implementation.
WASHINGTON – In a June 21 letter to the Office of the Inspector General (OIG), Reps. Glenn Thompson, R-Pa., and Bruce Braley, D-Iowa, call on the agency to investigate the possibility that CMS deliberately overlooked its own rules when awarding contracts for competitive bidding, according to a press release.
The OIG is charged with identifying and combating waste, fraud and abuse in more than 300 programs, including Medicare.
“We have asked the Inspector General to look into the shortfalls, but also to investigate the possibility that officials at Medicare intentionally ignored their own rules when problems began to arise,” Thompson stated.
The Centers for Medicare & Medicaid Services (CMS) reportedly is developing a new integrity contractor called a Unified Program Integrity Contractor (UPIC).
These contractors will focus on both Medicare and Medicaid integrity issues, and the Zone Program Integrity Contractors (ZPICs) and the Medicare Administrative Contractors (MACs) will be folded into the UPICs, according to an email sent last Friday by Dianne De La Mare, vice president of legal affairs for the American Health Care Association (AHCA).
De La Mar was reporting on what she described in her email as a conference call held last Friday by CMS Program Integrity. She added that MACs would not be going away; however, their integrity responsibilities will be folded into those of the UPICs.
Writing that the Medicaid Integrity Contractors (MICs), will be phased out, De La Mar also indicated that the recovery auditors will remain in place. Moreover, she concluded, CMS will be consolidating all of its Medicare and Medicaid data into one unified database.
Medicare and the FDA (Food and Drug Administration) are choosing to lower costs at the expense of your health. They are allowing cheap and faulty blood sugar test strips into the marketplace. Test strips that have been proven — the FDA admits — to give inaccurate glucose readings.
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