ICD10monitor July 8, 2024
Timothy Powell, CPA, CHCP

On June 28, the Centers for Medicare & Medicaid Services (CMS) announced a Proposed Rule titled Medicare Program: Mitigating the Impact of Significant, Anomalous, and Highly Suspect Billing Activity on Medicare Shared Savings Program Financial Calculations in Calendar Year 2023 (CMS-1799-P). While CMS touts this rule as a step forward in addressing billing abuses within the Medicare Shared Savings Program, it raises questions about the agency’s historical efficacy and commitment to combating fraud.

The Shared Savings Program is designed to promote accountability for the healthcare of Medicare beneficiaries and encourage efficient service delivery. However, recent trends in billing activities, specifically concerning durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), have prompted concerns about the integrity of financial calculations. In the...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: ACO (Accountable Care), CMS, Govt Agencies, Insurance, Medicare, Payment Models, Provider, Value Based
Gains in Capability, Losses in Access to Primary Care After COVID-19
Even modest meds adherence improvement can be financially transformative for health systems
CMS Moves Closer to Accountable Care Goals with 2025 ACO Initiatives
NAACOS Applauds Bipartisan House Bill on Value-Based Data Reporting
Late to APP Reporting? Untangle Your ACO’s Optimal Method

Share This Article