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October 2011

Recent Stories of Interest

From The HCCA-AIS Medicaid Compliance News - With an estimated $22 billion in fraud, waste and abuse in the Medicaid program alone, federal and state officials, along with representatives in the managed care industry, are setting in motion initiatives to improve Medicaid program integrity that are showing results in Medicare as well as other segments. “We will always be doing pay and chase” to some extent, Peter Budetti, M.D., CMS deputy administrator and director of the Center for Program Integrity, noted on Sept. 15 at the America’s Health Insurance Plans Medicaid Conference. Read more

CMS on Sept. 14 released its final rule on Medicaid recovery audit… Read more

It’s not a good sign when board members have no clue what… Read more

In two recent Medicaid recoupment cases, two organizations that committed the same… Read more

From the Editor

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November 23, 2011
CQ Healthbeat: Tavenner to Be Nominated Today to Succeed Berwick as CMS Administrator

Marilyn Tavenner will be nominated today to succeed Donald Berwick, M.D., as CMS administrator, CQ Healthbeat reports.

September 14, 2011
HHS Releases Final Medicaid RAC Rule

HHS issues final Medicaid recovery audit contractor rule; regs are effective Jan. 1. http://tinyurl.com/3qw6ktn

September 2, 2011
Calif. Billing Company Settle False Claims Case for $4.6M

A Calif. billing company has settled a Medicare/Medicaid false claims case for $4.6 million. http://tinyurl.com/3shpwph