How much money does Medicare waste?

September 9, 2012 in Medicaid/Medicare, Medicare The answer depends on who you ask. According to the GAO, Medicare spent $48 billion in “improper payments,” which include fraud but also waste, eligibility errors, miscoded claims and insufficient documentation. GAO determined that Medicare’s traditional fee-for-service plan had a 10.5 percent error rate. Attorney General Eric Holder, suggest there may be $60 […]

Face the Facts USA: One-third of Medicare goes for last months of chronically ill

Mercury News: 09/08/2012 Each day in the 100 days leading up to Election Day, and Face the Facts USA will be partnering to bring you one exhaustively researched and vetted, non-partisan fact about a major issue facing our nation. One third of total Medicare spending goes to treat chronically ill Medicare patients in the last […]

Out-of-Pocket Spending in the Last Five Years of Life

Out-of-Pocket Spending in the Last Five Years of Life Amy S. Kelley, Kathleen McGarry, Sean Fahle, Samuel M. Marshall and Qingling Du, et al. Journal of General Internal Medicine, Online First™, 4 September 2012 Read more

Are Medicare's New Quality Incentives Large Enough To Change Hospital Behavior?

By Jordan Rau, KHN Staff Writer, SEP 04, 2012   Update Sept. 5, 2012, at 12:38 p.m. With Medicare poised next month to give bonuses and penalties to hospitals based on how they ranked in quality standards, a number of health policy experts are questioning whether the amounts of money at stake are large enough to make a […]

CMS enlists pharmacies to advertise free Medicare benefits

Amednews: By CHARLES FIEGL, amednews staff. Posted Aug. 31, 2012. Washington Federal health officials have partnered with pharmacies to distribute information to Medicare patients about coverage benefits and preventive health services. CVS Caremark, Walgreens and other national drugstore chains are distributing Medicare brochures and other materials describing benefits for physician services to patients picking up medication orders. Since 2011, the […]

Medicare auditors becoming more active, denying more claims, survey shows McKnight’s Staff August 29, 2012 Requests for medical records by Medicare’s fraud-detecting recovery audit contractors (RACs) jumped sharply from the first- to the second-quarter of fiscal year 2012, a new survey reveals. RACs, which are contracted by the Centers for Medicare & Medicaid Services to detect healthcare fraud and recover Medicare and Medicaid overpayments from providers, […]


CMS Office of Public Affairs: Friday, August 24, 2012. Today, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced a final rule that will save time and money for physicians and other health care providers by establishing a unique health plan identifier (HPID). The rule is one of a series of changes required by the […]

No Evidence of the Effect of the Interventions to Combat Health Care Fraud and Abuse: A Systematic Review of Literature 8/24/12 Despite the importance of health care fraud and the political, legislative and administrative attentions paid to it, combating fraud remains a challenge to the health systems. We aimed to identify, categorize and assess the effectiveness of the interventions to combat health care fraud and abuse. Read More

Recessions and seniors’ health, health behaviors, and healthcare use: Analysis of the Medicare Current Beneficiary Survey 8/28/12 A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the […]

Stage 2 8/28/12 CMS recently published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. All providers must achieve meaningful use under the Stage 1 criteria before […]

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