HHS Takes Another Shot at Reducing Medicare Appeals Backlog

In an effort to clear the ever-growing Medicare appeals backlog, the U.S. Department of Health & Human Services has announced the launch of two new settlement options for providers and suppliers: a low-volume appeals (LVA) settlement and an expanded Settlement Conference Facilitation (SCF) process. LVA will be limited to appellants with a low volume of […]

GAO: CMS Fraud Prevention Working

The days of “pay and chase” in the world of healthcare fraud are waning thanks to fraud prevention methods that the Centers for Medicare and Medicaid Services have put into place. A newly released report from the Government Accountability Office (GAO) finds that Fraud Prevention System (FPS), which analyzes fee-for-service claims to identify healthcare providers […]