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FY2014 RAC Report To Congress: RACs Remain A Valuable, Accurate Integrity Tool

FOR IMMEDIATE RELEASE CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995 FY2014 RAC Report To Congress: RACs Remain A Valuable, Accurate Integrity Tool  Washington, D.C. – The Centers for Medicare and Medicaid Services (CMS) have released the Medicare fee-for-service Recovery Audit Program’s annual report to Congress for the fiscal year 2014. The report shares that Recovery Audit Contractors (RACs) returned more than $2.39 billion in Medicare improper payments and maintained their average accuracy score of more than 96%. According to the report, […]

KCUR-FM: Report: Saint Luke’s Hospital Overbilled Medicare By $581,000

Report: Saint Luke’s Hospital Overbilled Medicare By $581,000 Saint Luke’s Hospital of Kansas City overbilled Medicare $581,000 over a two-year period, a federal report concludes. The report by the Department of Health and Human Services’ Office of Inspector General (OIG) says the hospital failed to comply with Medicare requirements for 80 of 294 inpatient and outpatient claims reviewed by OIG. The federal watchdog says that 63 inpatient claims had billing errors, resulting in $366,584 in overpayments, and 17 outpatient claims […]

Bloomberg BNA: Medicare Appeals Backlog Could Be Reduced By Restructuring Process, Senator Says

From Bloomberg BNA: Medicare Appeals Backlog Could Be Reduced By Restructuring Process, Senator Says From Health Care Daily Report By James Swann April 28 — A current backlog of more than 500,000 unresolved Medicare appeals could be reduced by funneling only the most complex appeals to administrative law judges (ALJs), Sen. Ron Wyden (D-Ore.) said during a Senate Finance Committee hearing April 28. Medicare appeals involve claims denied by Recovery Audit Contractors (RACs) and other Medicare contractors because of questions concerning their propriety. […]

McKnight’s: Providers suffering Medicare appeals backlog — at their own hand?

From McKnight’s: Providers suffering Medicare appeals backlog — at their own hand? More than a half million appeals are not moving through the system, causing disruptions for beneficiaries and providers alike. The solution, according to Recovery Audit Contractors — which are rewarded incrementally for uncovering the incorrect payments so voluminously being challenged — lies in making providers put their money where there mouth is. RAC advocates say they’re fully behind an administration proposal to make appellants pay an appeal filing […]

Washington Hospitals Overbilled Medicare $50 Million

FOR IMMEDIATE RELEASE                        CONTACT: Kristin Walter kristin.walter@rubinmeyer.com (202) 898-0995  Washington Hospitals Overbilled Medicare $50 Million Washington, D.C. – Washington state ranks number 24 on a list of worst states for Medicare waste, overbilling Medicare $50 million in 2013, according to the most recent annual report by the Center for Medicare and Medicaid Services (CMS). Improper Medicare billing among the state’s healthcare providers increased $11 million over the previous year. “With waste on the rise, it is vital to have policies […]

Inside Health Policy: Chief ALJ: Refundable Filing Fee Could Reduce New Appeals

From Inside Health Policy: Chief ALJ: Refundable Filing Fee Could Reduce New Appeals Chief Administrative Law Judge Nancy Griswold suggested a refundable filing fee paid by those appealing Medicare denials could help cut down on the number of appeals that reach the ALJs, though providers and suppliers have previously said such a fee would be unworkable and unfair to those who would have to wait not only to recoup funding from appeals decided in their favor but an extra fee […]

WOOD-TV: Medicare waste spikes in Michigan

From WOOD-TV: View the broadcast here. Medicare waste spikes in Michigan By Marlee GinterPublished: April 16, 2015, 10:50 pm Updated: April 16, 2015, 11:13 pm GRAND RAPIDS, Mich. (WOOD) — Michigan overpaid millions of dollars to health care providers who billed Medicare last year, a recent audit found — one of the highest figures in the country. Medicare is reported to have the highest rate of financial waste of any government agency, with tens of billions of dollars lost in […]

Forbes: Hospital Industry Raids The Medicare Trust Fund

From Forbes: Hospital Industry Raids The Medicare Trust Fund Every year, millions of Americans pay federal taxes to support government programs that provide health, wellness, and other benefits to those who need it most. One would assume that safeguards are in place to ensure that our taxpayer dollars are used appropriately and efficiently. However, a recent Government Accountability Office (GAO) report states that rampant waste exists within the Medicare program. In 2014 alone, Medicare overpaid hospitals and other healthcare providers nearly […]

McKnight’s: RAC battles move forward

From McKnight’s:   RAC battles move forward The debate over whether Recovery Audit Contractor audits are an incentive-laced system of provider harassment or a necessary tool to redistribute misspent Medicare funds continues. Neither side appears to be backing down. The American Hospital Association, representing both acute and post-acute care providers, has blamed incentive-guided contracted auditors for causing a “tremendous burden on hospitals and the appeals process.” Besides calling for more favorable short-stay reimbursements, the AHA and other provider groups want […]

Good Morning Four States: Missouri 4th Worst in Medicare Waste

From Good Morning Four States: Missouri 4th Worst in Medicare Waste WASHINGTON DC — A recent reports ranks Missouri as one of the ten worst states in Medicare waste. According to the Council for Medicare Integrity, Missouri had $170 million worth of Medicare overpayments using data from a 2013 Medicare and Medicaid service report to Congress, ranking them fourth in the country. Medicare Waste is the unintentional misuse of Medicare funds through inadvertent error from incorrect coding and billing. Missouri […]