Medical Economics July 1, 2024
Feds continue analyzing situation involving more than $2 billion in possible fraud.
Allegations of fraudulent billing for catheters in 2023 will not affect calculations when Medicare analyzes financial performance of accountable care organizations (ACOs).
The U.S. Centers for Medicare & Medicaid Services (CMS) has opened a 30-day public comment period on its “Proposed Rule on Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023.” The proposed rule “is part of a larger strategy to address significant, anomalous, and highly suspect (SAHS)” billing within ACO reconciliation, according to CMS.
ACOs respond
The rule is potentially good news for the ACOs, some of which were the first to alert...
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