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...

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