Reimbursement
PPACA’s medical ratio loss rules continue to generate problems. Mini-med health plans, providing extremely modest coverage with low premiums, have been in the news this past week, with HHS’ announcement that plans offered by McDonalds and other low-wage employers will receive waivers from PPACA’s annual benefit limit provision to avoid potential termination of these plans.
HP Enterprise Services has been awarded a task order worth up to $26 million by the Centers for Medicare & Medicaid Services (CMS) to maintain its Integrated Data Repository (IDR) and provide data quality services to improve the accuracy of Medicare payment data.
Information technology and data mining capabilities had a role in dismantling what authorities are calling the largest Medicare fraud scheme ever, involving 73 members and associates of organized crime and more than $163 million in fraudulent billing.
A new survey shows that 84 percent of Medicare beneficiaries are satisfied with their coverage and more than 80 percent say their Part D premiums and co-payments are affordable.
The Centers for Medicare & Medicaid Services announced last month that the average premium for Medicare Advantage plans will be 1 percent lower in 2011.
The Department of Health and Human Services has proposed new rules to fight waste, fraud and abuse in Medicare, Medicaid and the Children's Health Insurance Program.
The Department of Health and Human Services has expanded the Rural Community Hospital demonstration program.
A study in the September issue of Health Affairs has pegged the cost of malpractice at approximately $55.6 billion a year, or 2.4 percent of annual healthcare spending.
A report on healthcare spending released in September by actuaries at the Centers for Medicare and Medicaid Services has been used to support both sides of the bitter partisan debate over healthcare reform.
A former chief financial officer for three different hospital networks is under house arrest and facing federal fraud charges for allegedly stealing more than $200,000 from health systems in Connecticut and Ohio.