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Category : Press Release

Twenty-One States Have Higher Medicare Overbilling Than The National Average

FOR IMMEDIATE RELEASE CONTACT: Kristin Walter kristin.walter@gowestfourth.com (202) 898-0995 Twenty-One States Have Higher Medicare Overbilling Than The National Average  Improper Billing Pushing Program to Bankruptcy Washington, D.C. – According to new data from the Centers for Medicare and Medicaid Services, 21 states are projected to have above average rates of overbilling Medicare for services. According to the Supplementary Appendices for the Medicare Fee-for-Service (FFS) 2015 Improper Payment Report, the national average for improper payments during that year was 12.1 percent, […]

2015/2016 Medicare Compliance Reports: Missouri Overbilled Medicare By More Than $2 Million

FOR IMMEDIATE RELEASE                                                                                      CONTACT: Kristin Walter kristin.walter@gowestfourth.com (202) 898-0995 2015/2016 Medicare Compliance Reports: Missouri Overbilled Medicare By More than $2 Million Washington, D.C. – A report released this week by the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that Freeman Hospital in Joplin, Missouri overbilled Medicare $311,447 from 2011to 2012. According to the OIG, 20 percent of the hospital’s Medicare claims were improperly billed. According to a 2015 report from the Centers for […]

RAC Facts: The State of the RAC Program

The State of the RAC Program A new trend report from the Council for Medicare Integrity (CMI) provides an overview of the current state of the Recovery Audit Contractor (RAC) Program. The analysis looks at: Updates on the Appeals Process: According to OMHA, in FY2015, the majority of appeals came from traditional workloads, not from RAC denials; RAC appeals made up only 19% percent of appeals. Providers continue to flood the Medicare process with appeal submissions expected to surpass one million by the […]

Advocacy Group Releases Analysis of Current State of the RAC Program

FOR IMMEDIATE RELEASE March 9, 2016 CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Advocacy Group Releases Analysis of Current State of the RAC Program Washington, D.C.– Today, the Council for Medicare Integrity (CMI) released a trend report reviewing and summarizing the current state of the Recovery Audit Contractor (RAC) Program. The analysis looks at: Updates on the Appeals Process: The Office of Medicare Hearings and Appeals (OMHA) has reported that the majority of FY2015 appeals came from traditional workloads, not RAC denials. […]

RAC Facts: Court Decision Highlights Need For Appeals Reform

Court Decision Highlights Need For Appeals Reform On February 9, 2016, the District of Columbia U.S. Circuit Court of Appeals reopened a lawsuit by the American Hospital Association against the U.S. government over delayed Medicare reimbursement appeals. CMS recently offered providers a settlement to clear the backlog of Medicare appeals, but new estimates show that providers are still filing an overwhelming number of appeals. However, most pending appeals are not on RAC improper payment decisions.  Despite the 96% accuracy rate […]

February Report: University of Minnesota Medical Center Overbilled Medicare $3.2 Million

FOR IMMEDIATE RELEASE                                                                                      CONTACT: Kelly Davis kelly.davis@rubinmeyer.com (202) 898-0995 February Report: University of Minnesota Medical Center Overbilled Medicare $3.2 Million Washington, D.C. – A report released this week by the U.S. Department of Health and Human Services Office of Inspector General found that the University of Minnesota Medical Center in Minneapolis overbilled Medicare $3,266,841 from 2012 to 2013.  According to the OIG, 51 percent of the hospital’s Medicare claims were improperly billed. According to the Council for Medicare […]

RAC Facts: Medicare Part A in Jeopardy, Congress Raises Concerns Over Limitations on RAC Program

Medicare Part A in Jeopardy, Congress Raises Concerns Over Limitations on RAC Program According to a new report from the Congressional Budget Office (CBO), the trust fund for Medicare Part A (hospital insurance) will be bankrupt by 2026 – in just 10 years.  The report projects that the fund’s annual expenditures will outpace income “in all years through 2026 except for 2018, producing annual deficits…that would rise to $54 billion in 2025, the final year before the fund was exhausted.” […]

Top 10 States with Highest Medicare Waste

FOR IMMEDIATE RELEASE                                                CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Top 10 States with Highest Medicare Waste  Council for Medicare Integrity releases analysis of states’ Medicare waste Washington, D.C. – The Council for Medicare Integrity (CMI) today released an analysis of waste within the Medicare Fee-For-Service program. The analysis, which looks at how much money each state wastes per beneficiary, found that the District of Columbia has the highest amount of Medicare waste per beneficiary among in the entire United States with $177.84 […]

Avalere Analysis: Continuing The Pause in RAC Program Will Cost Medicare $47 Billion

FOR IMMEDIATE RELEASE                                  October 27, 2015   CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 Continuing The Pause in RAC Program Will Cost Medicare $47 Billion Avalere analysis determines federal Medicare spending will significantly increase over the next 10 years at current RAC recovery levels Washington, D.C. – Today, an analysis from Avalere Health reveals that the federal government will increase spending on Medicare by $47 billion over the 2016-2025 budget window if the pause in the Recovery Audit […]

RAC Facts: Trend Report Identifies Top 5 Medicare Billing Issue Areas That Put Taxpayer Dollars At Risk

Trend Report Identifies Top 5 Medicare Billing Issue Areas That Put Taxpayer Dollars At Risk A new trend report from the Council for Medicare Integrity identifies the top five CMS-approved billing issues that contribute most to Medicare waste. The issues include: Durable Medical Equipment (DME): According to the CMS Comprehensive Error Rate Testing (CERT) program, in FY2014, the error rate among DME billing was 53.1%, accounting for $5 billion in improper payments. Home Health Claims: In FY2014, CMS reported that the […]