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Home health agency owner 20-year sentence for Medicare fraud upheld

The Eleventh Circuit Court of Appeal recently affirmed a 20-year prison sentence for the owner of a Miami home healthcare business who was found guilty of Medicare fraud. Dora Moreira, the owner and operator of Anna Nursing Services Corp., was accused of bilking Medicare out of $7 million. The appellate court found that Moreira, who […]

Now is the time to protect against cyberthieves

For the second time in as many months, a major healthcare insurer has become the target of cyberthieves. This week, Premera Blue Cross announced it had been the target of hackers who gained access to the financial and medical information of 11 million members. In February, Anthem, Inc., announced that personal information of around 80 […]

CMS announces next generation of ACO model

The Centers for Medicare & Medicaid this week launched a new Accountable Care Organization model that the agency says will “reward value over volume in care delivery.” The Next Generation ACO Model, as it has been named, is an initiative from CMS’ Innovation Center. ACOs are groups of providers that contract with the Medicare program […]

GAO: Government misspent billions on Medicare/Medicaid

Last year, Medicare financed health services for approximately 54 million elderly and disabled beneficiaries at a total cost of $603 billion. Of that, approximately $60 billion went toward improper payments, according to a report issued last week by the Government Accountability Office (GAO) Most of that misspent money, about $45.8 billion, went toward the Medicare […]

CMS says ICD-10 testing successful: Are you prepared?

The Centers for Medicare and Medicaid Services is reporting that it successfully completed the first week of end-to-end testing of the soon-to-be-implemented ICD-10 coding. The testing, which took place between Jan. 26 and Feb. 3, included 661 participants with about 1,400 National Provider Identifiers registered. They were split equally between direct submitters and clearing houses/billing […]

GAO: CMS ready for ICD-10, but are you?

There is good news for healthcare providers coming out of the Government Accountability Office: The Centers for Medicare and Medicaid Services is prepared for the switch to ICD-10 on Oct. 1, according to a newly released report. The 41-page report notes that CMS has undertaken “a number of efforts” to prepare for transition to the […]

Florida lawmakers introduce telemedicine legislation

Florida could see legislation later this year that would create statewide guidelines on the use of telemedicine. A bipartisan bill has been filed in Tallahassee that, if signed into law, would more clearly define what telehealth is, who is considered a telehealth provider and outlines what the standard of care is for those providers. HB […]

CMS extends moratoria for home health agencies, ambulance suppliers

The Centers for Medicare and Medicaid Services (CMS) is continuing its crackdown on fraud and abuse and South Florida providers are, not surprisingly, on its hit list. CMS announced on Jan. 30, new temporary moratoria on the enrollment of home health agencies in four cities including Fort Lauderdale. It also is extending, for another six […]

CMS to modify requirements for Meaningful Use

Bowing to pressure from physician groups, the Centers for Medicare & Medicaid Services (CMS), announced on Jan. 29 that it would amend its requirements for healthcare providers to meet meaningful use in the Medicare and Medicaid Electronic Health Record (EHR) Incentive programs. Among the most significant of these changes is to shorten the Meaningful Use […]

HHS: Medicare payments to be tied to quality, not quantity

The U.S. Department of Health and Human Services announced this week that future Medicare payments will be linked to quality and not quantity. This is the first time the federal agency has set specific goals designed to move away from plans that reward providers for the amount of care they provide instead of the quality […]

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