Healthcare Innovation April 11, 2024
David Raths

Center for Medicare and Medicaid Innovation’s Elizabeth Fowler anticipates being able to share an approach in ACO REACH for anomalous billing related to catheters in the coming weeks

At this week’s spring meeting of the National Association of ACOs (NAACOS), officials from the Centers for Medicare & Medicaid Services were asked to respond to growing concerns about the impact of widespread anomalous billing and suspected fraud involving urinary catheters that is impacting Medicare ACO results.

According to a February 2024 story in the New York Times, more than 450,000 Medicare beneficiaries accounts were billed for urinary catheters in 2023, up from about 50,000 in previous years. The data came from a report produced by the Institute for Accountable Care...

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Topics: ACO (Accountable Care), CMS, Govt Agencies, Insurance, Medicare, Payment Models, Provider, Value Based
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