Healthcare Law Blog

FEBRUARY 1, 2023

The Final Rule implements the following changes: CMS will extrapolate RADV audit findings beginning with payment year (“PY”) 2018 and will not extrapolate RADV audit findings for PYs 2011 through 2017. case number 18-5326 , which reinstated CMS’s Overpayment Rule for MA organizations. Becerra et al.,

Medicare 105

Medicare Medicare Overpayments Overpayment 105

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). CMS cites to 2017 to show that from 2017 to today, agencies have reduced the number of visits per episode by 16%.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

Kaiser Health News

JUNE 29, 2022

They also called for the Centers for Medicare & Medicaid Services, or CMS, to revive a foundering audit program that is more than a decade behind in recouping billions in suspected overpayments to the health plans, which are run mostly by private insurance companies. Bliss said Medicare paid $2.6

Medicare 107

Medicare Medicare Governance Overpayments 107