Medicare | Dolbey Systems, Inc.

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Hospitals slammed with $380M in CMS cuts, industry cries foul

By Samantha Liss for Healthcare Dive Dive Brief: With its final Outpatient Prospective Payment System (OPPS) rule for 2019, CMS is eliminating the pay discrepancy Medicare beneficiaries face visiting a hospital-owned outpatient setting as opposed to a traditional doctor’s office. CMS said cutting reimbursement at hospital-owned outpatient settings for these visits will save Medicare $380 million…

Posted on:Nov 15, 2018

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CMS bid to overhaul E/M codes leaves few happy

With its proposed changes to payments and documentation for office visits, the agency is effectively forcing providers to reckon with a longstanding, oft-disputed problem. By Tony Abraham for Healthcare Dive Most healthcare players agree the evaluation and management billing codes used by CMS need an overhaul, but few like the manner to do so proposed…

Posted on:Oct 18, 2018

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8 most common medical coding errors

By Morgan Haefner for Becker’s Hospital Review In June, federal officials charged 601 defendants in alleged schemes involving about $2 billion in costs to Medicare and Medicaid, the biggest healthcare fraud enforcement action in U.S. Justice Department history. Government and private health insurer audits have recently revealed several fraudulent or abusive medical billing practices, Kevin B. O’Reilly, editor…

Posted on:Aug 23, 2018

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Health Care Goodfellas: Mafia Turns to Medicare Fraud

By Edecio Martinez for CBS News MIAMI (AP) Lured by easier money and shorter prison sentences, Mafia figures and other violent criminals are increasingly moving into fraud involving the government’s Medicare health insurance program for the elderly. Around the U.S., federal investigators have been threatened, an informant’s body was found riddled with bullets, and a woman was…

Posted on:Aug 9, 2018

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CMS finalizes rule requiring hospitals to post prices online

By Tony Abraham for Healthcare Dive Dive Brief: CMS on Thursday issued its final rule on the Inpatient Prospective Payment System, cementing the agency’s April proposal to increase transparency by pushing hospitals to post standard charges online in a machine-readable format. The rule doesn’t require posting any more information than hospitals are already mandated to provide…