9 Recent Medicare, Medicaid Issues

Here are nine issues dealing with Medicare or Medicaid that occurred in the past week, starting with the most recent.


1. HHS and the Department of Justice announced its Medicare Fraud Strike Force has charged 91 people — ranging from hospital administrators to physicians — for allegedly billing Medicare for $429.2 million in false claims. One fraud scheme allegedly involved a hospital in Houston. Earnest Gibson III, CEO of Riverside General Hospital, his son and five others were charged with fraudulently billing $158 million for community mental health center services.

2. The HHS Office of Inspector General released its work plan for fiscal year 2013, a portion of which details the activities it will conduct in its review of Medicare payments and hospital services in the upcoming year.

3. A study in Health Affairs found the Medicare Shared Savings Program may generate only limited savings for participating accountable care organizations.

4. Several Georgia hospital organizations have fired back at anti-tax lobbyist Grover Norquist, who recently said a renewal of the Georgia Medicaid provider fee would raise healthcare costs and eliminate job growth.

5. CMS issued a notice admitting technical errors that caused the agency to miscalculate penalties under the Readmissions Reduction Program. The technical error means 1,422 hospitals will lose more money than previously expected, and 55 hospitals will lose less money.

6. President Barack Obama and Republican presidential candidate Mitt Romney squared off in the first of three debates this week, and a significant portion of the first debate was devoted to Medicare and general healthcare.

7. Rep. Joseph Crowley (D-N.Y.) pushed legislation that would increase the number of Medicare-supported residencies by 15,000 over the next five years — expanding a cap that has not been touched in 15 years.

8. Buffalo, N.Y.-based Kaleida Health agreed to pay $1.6 million after a state attorney general investigation revealed the system overbilled Medicaid for dental clinic services for which reimbursement was not authorized.

9. The Seventh U.S. Circuit Court of Appeals upheld a lower court's injunction against annual caps on medically necessary dental care in Indiana's Medicaid program.

More Articles on Medicare and Medicaid:

Prepping for the Fiscal 2013 Wave: Q&A With Greg Damron, CFO of Georgia Health Sciences Medical Center

7 Recent Medicare, Medicaid Issues

Discerning the Difference: 5 Answers on Obama's, Romney's Medicare Plans

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