Although medical providers are prohibited from billing patients for costs that aren't covered by Medi-Cal, California's low income insurance plan, patient advocates say they are receiving an increasing number of complaints regarding the practice known as balance billing.
Medicare's five-star scale that rates the quality of care provided at hospitals doesn't offer a complete picture because it fails to reflect the distinct socioeconomic and demographic factors of vulnerable patients, according to hospital advocacy groups.
A whistleblower lawsuit filed in 2009 against Carolinas Medical Center (CMC) in Charlotte, North Carolina, and N.C. Baptist Hospital in Winston-Salem, claims the providers raked in tens of millions in unsubstantiated Medicare funding by falsely reporting their benefit expenses.
The now three-year-old codes for Medicare's annual wellness visit "look good on paper, [but] they don't work out in practice," Paul Speckart, M.D., an internist in San Diego, recently told MedPage Today.
The Obama administration is zeroing in on fraud, waste and abuse, as evidenced by a letter from a White House official calling for "a more aggressive strategy" to combat improper payments within government healthcare programs.
As the Oct. 1 ICD-10 deadline inches closer, many insurers haven't announced whether they have implemented accommodation periods--when they will pay claims that aren't coded correctly as long as they're in the right family of codes, reports Health Data Management.
For years, health insurance companies have claimed that Medicare Advantage can provide better care at a lower cost. But is this really the case?
In a sign that hospitals and the Centers for Medicare & Medicaid Services are moving closer to an agreement over the controversial two-midnight rule regarding inpatient admissions, the American Hospital Association has praised changes that have been proposed by the agency--but it still wants more time before those changes go into effect.
The issue of observation care has proven to be a financial sore point for hospitals, but a new study suggests it is creating similar issues for patients, according to a new study published in the Journal of Hospital Medicine.
A critical decision on ownership nearly four decades ago ensured the future survival of one Arizona community hospital but potentially led to the recent closure of another, according to an article in the Silver City Daily Press.