Healthcare Innovation July 1, 2024
CMS proposes to exclude codes related to urinary catheter billing in assessing financial performance of Shared Savings Program ACOs
Stakeholders are pleased with a Centers for Medicare & Medicaid Services (CMS) proposed rule to address the impact of widespread anomalous billing and suspected fraud involving urinary catheters that impacted Medicare accountable care organization (ACO) results.
According to a Feb. 24 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 and NAACOS. “The massive uptick in billing for catheters included $2 billion charged by seven high-volume suppliers, according to that...
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