Medicare Billing

Latest Headlines

Latest Headlines

New fraud prevention rule gives CMS greater discretion

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule focusing on new safeguards to reduce Medicare fraud. The new rule gives CMS the "ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare."

Hospital False Claims settlement shows value of self-monitoring, voluntary disclosure

Our Lady of Lourdes Memorial Hospital in Binghamton, New York, paid more than $3 million to resolve False Claims Act liability stemming from its Medicare billing, the U.S. Attorney's office for the Northern District of New York announced.

HHS sued for access to Medicare Advantage info

The U.S. Department of Health and Human Services still has yet to provide information related to its oversight of Medicare Advantage insurers, according to a new lawsuit issued against the federal agency.

OIG: Washington Hospital must repay $1M in Medicare reimbursements

An Office of the Inspector General audit reveals MedStar Health's Washington Hospital in Washington, D.C., overbilled Medicare more than $1.06 million in 2010 and 2011. 

Wayne Medical Center to pay $880K to settle self-reported overbilling charges

Wayne Medical Center, part of Tennessee's Maury Regional Medical Center, has agreed to pay $883,451 to settle self-reported allegations of improper Medicare billing.

Baylor Health to pay $900K in double billing settlement

Baylor University Medical Center in Dallas has agreed to pay more than $900,000 to settle allegations that it submitted false claims to Medicare for radiation oncology services, the U.S. Justice Department announced yesterday.

Billing trends could signal rise in upcoding

Physicians have been billing Medicare for increasingly complex--and more expensive--procedures over the past 10 years, signaling a growing upcoding trend that adds $11 billion to healthcare costs.

Ex-case manager director blows whistle on health system Medicare fraud

Texas-based Christus Spohn Health System has paid more than $5.1 million to settle allegations that its hospitals falsely billed Medicare, the United States Attorney's Office said Thursday.

Hospitals retrain staff on Medicare compliance after OIG audits

Two more reports from the Office of Inspector General last week reveal that hospitals not understanding billing requirements led to Medicare overpayments at Bay Medical Center in Panama City, Fla.,

Inadequate training, staff errors lead to Medicare overpayments at Jefferson, other hospitals

Hospitals are chalking up Medicare overpayments to inadequate training and inadvertent errors in three recent audits by the Office of the Inspector General, released last month. For example, Thomas