Latest Headlines

Latest Headlines

Mental health scams target Medicare and Medicaid

Fraud involving Medicare and Medicaid mental health benefits has been "a special enforcement problem that stretches back decades," according to former Department of Health and Human Services Inspector General Richard P. Kusserow. 

GAO report: CMS financial records don't line up

The Centers for Medicare & Medicaid Services lacks a sound financial management system,  according to a new report issued by the Government Accountability Office.

Are ACO operators eyeing Medicare Advantage instead?

The challenges of operating an ACO that cuts costs without losing money can be so daunting that some ACO operators may launch a M edicare Advantage  health plan to replace it, a ccording to   Healthcare Finance News.

A tip of the hat to Senior Medicare Patrols

September is healthcare fraud awareness and prevention month, and that makes this a good time to acknowledge the work of Senior Medicare Patrols. SMPs are a national project run by states to teach...

Cancer doc admits guilt in unnecessary chemo scheme

Michigan oncologist Farid Fata, M.D., awaiting trial for orchestrating a multi-million dollar Medicare fraud scheme, entered a surprise guilty plea yesterday to 13 counts of healthcare fraud, two counts of money laundering and one count of conspiracy to pay and receive kickbacks, the Detroit Free Press reported.

Feds crack down on therapeutic services fraud

Recent enforcement actions by the U.S. Department of Justice showcase federal efforts to put the kibosh on fraudulent claims filed with government programs for therapeutic services.

Lawsuit seeks reversal of CMS amyloid reimbursement policy

A lawsuit has been filed in federal court against the Centers for Medicare & Medicaid Services in an effort to get it to change its policy regarding Medicare reimbursement for the use of PET beta-amyloid scans to detect Alzheimer's disease.

More evidence supports Medicare coverage of LDCT screening

A secondary analysis of the National Lung Screening Trial has found that low-dose lung cancer screening is actually more effective for older high-risk patients than it is for younger ones, according to a study in the  Annals of Internal Medicine.

Why CMS should reimburse for secondary imaging interpretations

The comment period for the 2015 Medicare Physician Fee Schedule proposed rule ended last week and radiology and imaging-related organizations expressed their concerns about a number of issues, such as the potential for significant reimbursement reductions in radiation oncology services. One area of particular interest to these organizations has to do with the payment for the secondary interpretation of images.

Study: Low Dose CT lung cancer screening saves lives, cuts costs

Low-dose CT lung cancer screening is cost-effective and saves lives, according to a new study in  American Health and Drug Benefits.