Fierce Healthcare April 11, 2024
Paige Minemyer

Accountable care organizations have sounded the alarm on billions in durable medical equipment fraud, and officials at the Centers for Medicare & Medicaid Services (CMS) said Thursday that the agency is monitoring the issue.

The National Association of ACOs (NAACOS) told the feds that a review of data from CMS’ Virtual Research Data Center found a spike in payments related to two billing codes. Payments for urinary catheters grew from $153 million in 2021 to an eye-popping $2.1 billion in 2023.

NAACOS said the spike in costs could significantly impact ACOs’ finances, slashing savings and potentially impacting benchmark payments.

Liz Fowler, Ph.D., director of the Center for Medicare and Medicaid Innovation, said at NAACOS’ spring conference Thursday morning that the...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: ACO (Accountable Care), CMS, Govt Agencies, Insurance, Medicare, Payment Models, Provider, Value Based
For Rural ACOs, New Primary Care Model From CMS Offers Much-Needed Financial Help
Does physician-hospital integration reduce ACO cost?
The Rise of Capitation: How Tech Optimizes Finances for Payers and Providers
Equity Through Episode-Based Payment: Features Of The Transforming Episode Accountability Model
Navigating MSSP Quality Reporting

Share This Article