GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Excerpts from this story referencing "Medicaid Services":

"… spring. GAO auditors will target efforts by the Centers for Medicare and Medicaid Services (CMS), which runs the senior care program, to ensure the privately run hea …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Insurance":

"… boost payment rates. Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group, said the higher billing resulted from …"

Center sues in an effort to make Medicare Advantage files public

By Fred Schulte

Center sues to make records public.

Excerpts from this story referencing "Medicaid":

"… r reporter Fred Schulte requested records from the Centers of Medicare and Medicaid Services (CMS), an arm of HHS, in a May 21, 2013, letter. The letter asked …"

Feds propose shakeup for emergency room billing

By Fred Schulte

Proposal seeks to counter alleged over-billing with standardized rate

ObamaCare oversight among health watchdog cuts

By Fred Schulte

Trims include ObamaCare oversight

Feds 'listen' for sounds of Medicare billing abuse

By Fred Schulte

Baltimore session looks at role of electronic health records in higher medical bills.

Excerpts from this story referencing "Kathleen Sebelius":

"… ent officials swung into action. U.S. Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder fired off a stern letter to five prominen …"

GOP senators call for overhaul of electronic health records program

By Fred Schulte

Report says $35 billion Obama administration stimulus program not working

Excerpts from this story referencing "Lamar Alexander":

"… dopt Health IT” was released on Tuesday by Senators John Thune (R-S.D.), Lamar Alexander (R-Tenn.), Pat Roberts (R-Kan.), Richard Burr (R-N.C.), Tom Coburn (R-Okla …"

Electronic medical records probed for over-billing

By Fred Schulte

Are feds doing all they can to ferret out waste from move to electronic records?

Feds tighten scrutiny of health records

By Fred Schulte

Feds increase scrutiny of how electronic systems affect billing

Excerpts from this story referencing "Medicare fraud":

"… ruary 2009.  …"

Hospitals request government help in curbing possible billing abuses

By Fred Schulte

Federal help sought to create billing guidelines and oversee electronic medical records

Excerpts from this story referencing "Kathleen Sebelius":

"… . The letter was sent to Department of Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder.“Hospitals share the administration’s …"

IMPACT: HHS IG pledges focus on Medicare billing abuse involving electronic records

By Fred Schulte

HHS inspector general announces focus on Medicare billing abuse involving electronic records

IMPACT: Administration official asks for Medicare billing review

By Fred Schulte

Administration official wants to know if electronic health records are causing Medicare over-billing

Excerpts from this story referencing "disease":

"… from millions of patients in the hope of discovering better ways to treat disease and cut costs.But the push for better quality medicine is facing off again …"

Top House Republicans demand suspension of electronic medical records program

By Fred Schulte

Top House Republicans want program suspended until government demands that systems communicate

Suit alleges retaliation for exposure of upcoding

By Fred Schulte

Nevada woman claims she was fired after questioning hospital's bills

Excerpts from this story referencing "electronic systems":

"… eyond threats of prosecution” and focus on adding fraud detection to the electronic systems sold to doctors and hospitals.As officials in Washington step up scrutiny …"

IMPACT: Cabinet officials signal crackdown on Medicare billing abuse

By Fred Schulte and Joe Eaton

Sebelius, Holder signal new scrutiny in wake of Center series

Excerpts from this story referencing "Medicare fraud":

"… dgment by top federal officials that the digital era may spawn more costly Medicare fraud and billing abuse. In the past, federal officials have largely accepted th …"

OPINION: Center series demonstrates dangers of 'captured' regulators

By Wendell Potter

Center series demonstrates dangers of special interest influence

Excerpts from this story referencing "Medicaid Services":

"… affecting them. In many regards,  the Centers for  Medicare and Medicaid Services (CMS) has become a “captured agency” as a result of decisions made dec …"

Grassley says providers who overbill Medicare are draining its finances

By Fred Schulte

Grassley says providers charging too much threaten program's shaky finances

Billing complexity spawns new industry

By Fred Schulte

Thousands now employed as professional coders, but oversight is lacking.

Hospitals grab at least $1 billion in extra fees for emergency room visits

By Joe Eaton and David Donald

Center probe suggests facilities have taken advantage of government’s failure to set billing standards.

Growth of electronic medical records eases path to inflated bills

By Fred Schulte

Billing software helps medical professionals document higher fees.

Excerpts from this story referencing "Robert Tennant":

"… o catch up with billing practices that for years did not pay them enough. Robert Tennant, a Washington lobbyist with the Medical Group Management Association, whic …"

How doctors and hospitals have collected billions in questionable Medicare fees

By Fred Schulte and David Donald

Center investigation suggests cost from upcoding and other abuses likely tops $11 billion.

Excerpts from this story referencing "Medicare fraud":

"… Obama administration has made a significant commitment to cracking down on Medicare fraud and abuse, officials don’t appear to have an aggressive strategy for cut …"

Methodology for 'Cracking the Codes'

By David Donald

A glimpse into the data analysis for this investigation.

Judgment calls on billing make 'upcoding' prosecutions rare

By Fred Schulte

Authorities typically settle, and doctors often continue treating Medicare patients

HHS IG report highlights docs' questionable billing of Medicare

By Fred Schulte

HHS IG report says thousand of doctors billing feds at rates beyond the norm

Excerpts from this story referencing "Center for Public Integrity":

"… rovide and begin paying them based on the quality of care they provide.The Center for Public Integrity is conducting an in-depth reporting project examining Medicare spending an …"

Medicare fraud: What you need to know

By Sarah Whitmire

Last week's biggest-ever Medicare fraud bust nabbed 107 care providers, but how does this effort stack up?

Excerpts from this story referencing "Medicare fraud":

"… that directs Medicare spending in often-inefficient ways.The big story in Medicare fraud last week was an unprecedented bust of 107 doctors, nurses and social work …"

"… , as reported by the Associated Press. Though the crackdown was huge, Medicare fraud is believed to cost up to $90 billion annually, the scams associated with …"

"… 011 alone) in medical services that never happened.Places to learn more:“Medicare fraud rampant in South Florida”, by The Miami Herald, August 3, 2008“11 …"

"… th Florida”, by The Miami Herald, August 3, 2008“111 charged with Medicare fraud in 9 cities” by The Washington Times, February 17, 2011“Feds Figh …"

Senators want more aggressive action to curb rampant Medicare fraud

By Joe Eaton

Hatch, Coburn, says federal health program for the elderly isn't weeding out scamsters, bad doctors

Excerpts from this story referencing "Medicaid Services":

"… he letter to Donald Berwick, administrator of the Centers for Medicare and Medicaid Services (CMS), Sen. Orrin Hatch, R-Utah, and Sen. Tom Coburn, R-Oklahoma, wrote th …"

$100 million for artificial legs and feet in question

By Alexandra Duszak

Medicare IG report bares $100 million in questionable costs for artificial legs, feet

Excerpts from this story referencing "Wyoming":

"… for artificial legs and feet, including suppliers in Alabama, Mississippi, Wyoming and Puerto Rico who were twice as likely to turn up in the inspector gener …"

"… suppliers for privacy reasons.As for Alabama, Mississippi, Puerto Rico and Wyoming, White said it was impossible to say exactly why these areas have become h …"

Medicare paid $47.9 billion for unneeded, miscoded or undocumented health care

By Alexandra Duszak

Medicare spent almost $50 billion on unneeded, undocumented or miscoded health care

GAO: Almost a tenth of Medicare spending was improper

By Laurel Adams

An estimated $48 billion went to improper Medicare payments last year, out of the $509 billion spent on health care for elderly and disabled

Medicare fraud included phantom services, equipment

By Laurel Adams

A sampling of Medicare providers who were overpaid by $206 million in 2007-08 showed some billed the government for phantom services or for

Excerpts from this story referencing "Medicare fraud":

"… f the providers were located in U.S. Attorney districts that have set up a Medicare fraud team.Following are other new watchdog reports released by the Government A …"

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