Improper payments to healthcare providers cost the Medicaid program approximately $17.5 billion in fiscal year 2014, according to a new report from the HHS Office of the Inspector General. The reason: States’ failure to fully implement or properly use Medicaid National Correct Coding Initiative (NCCI) edits. The purpose of the NCCI edits is to prevent…

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The Centers for Medicare & Medicaid (CMS) earlier this month released its much- anticipated Final Rule updating the Medicare Shared Savings Program. The whole concept behind the program, created by the Affordable Care Act (ACA), is to encourage participation among providers through the use of accountable care organizations (ACOs). ACOs are groups of providers that…

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