Since the Centers for Medicare & Medicaid Services (CMS) released its Final Rule on "Ensuring Access to Medicaid Services" on Monday, April 22, many in the industry have voiced their disappointment in the rule, including the National Association for Home Care & H
CMS/Medicare
The Centers for Medicare & Medicaid Services (CMS) is a department of Health and Human Services (HHS). The current administrator is Seema Verma, appointed by President Donald Trump.
CMS oversees the Medicare and Medicaid programs. CMS collects and analyzes data, produces research reports, and works to eliminate instances of fraud, waste and abuse within the health care system.
WASHINGTON—The Centers for Medicare & Medicaid Services released its Final Rule on "Ensuring Access to Medicaid Services" on Monday, April 22.
WASHINGTON—The National Association for Home Care & Hospice (NAHC) released a statement noting that it was, 'extremely disappointed that the Centers for Medicare and Medicaid Services (CMS) elected to finalize the “payment adequacy” provision in the Medicaid Access Final Rule (CMS 2442-F).'
BOSTON—The owner of Expansion Media (Expansion) and Hybrid Management Group (Hybrid) plead guilty on April 3 in connection with a $110 million telemedicine fraud scheme involving medically unnecessary durable medical equipment (DME), including orthotics such as back and knee braces.
WASHINGTON—On March 28, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1810-P) that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2025 in accordance with existing statutory and regulatory requirements.
WASHINGTON—The Centers for Medicare & Medicaid Services announced that the next Home Health, Hospice & DME Open Door Forum is scheduled for Wednesday, April 3, 2024, from 2-3:00 p.m. Eastern Time (ET).
Log on at least 15 minutes prior to the forum start time. The agenda is subject to change.
VERLAND PARK, Kansas—Netsmart, a provider of software and services for payers, providers and state Medicaid Agencies, announced the deployment of the Netsmart electronic visit verification (EVV) system for the Montana Department of Public Health & Human Services (DPHHS). This implementation facilitates statewide aggregation of critical health care data aligned with the 21st Century Cures Act.
COLUMBIA, South Carolina—Andrew Chmiel, 48, of Mt. Pleasant, was sentenced to nine years in federal prison for his role in a nearly $100 million scheme related to the payment of kickbacks and bribes in exchange for medically unnecessary durable medical equipment (DME) orders.
By Phil Galewitz and Holly K. Hacker
Billy Abbott, a retired Army medic, wakes at 6 a.m. every morning, steps on the bathroom scale, and uses a cuff to take his blood pressure.
WASHINGTON—U.S. Senators Bill Cassidy, M.D. (R-LA), Tom Carper (D-DE), John Cornyn (R-TX), Mark Warner (D-VA), Tim Scott (R-SC) and Bob Menendez (D-NJ), members of the Senate Duals Working Group, introduced the Delivering Unified Access to Lifesaving Services (DUALS) Act of 2024 to improve coverage for individuals jointly enrolled in Medicare and Medicaid, also known as dual eligibles.
The DUALS Act of 2024:
CHARLOTTE, North Carolina—Family First Home Health Care, Inc. (Family First), a home health care agency located in Gastonia, North Carolina, (now d/b/a Gaston Piedmont Health Care Inc.), and its owner Marion James have agreed to collectively pay $600,000 to resolve allegations that they knowingly violated the Federal and North Carolina False Claims Acts from Jan. 1, 2015, through Jan. 9, 2020, by submitting thousands of fraudulent claims to Medicaid for reimbursement, announced Dena J.
SAN DIEGO—Anthony Duane Bell Sr. and his son, Anthony Duane Bell Jr., were sentenced in federal court to 65 months and 12 months and one day, respectively, for their roles in fraudulently receiving more than $21 million in Medicare payments and lying to cover it up.
WASHINGTON—During a Ways & Means Committee hearing that examined opportunities and challenges in enhancing access to care in patients’ homes and modernizing care in rural and underserved communities, U.S. Rep.
FARGO, North Dakota—Noridian Healthcare Solutions, LLC (Noridian), a developer of solutions for federal, state and commercial health care programs, announced the re-award of the Durable Medical Equipmen
TRENTON, New Jersey—A Florida man admitted his role in a durable medical equipment (DME) kickback scheme, U.S. Attorney Philip R. Sellinger announced.
Steve Chicoye, 55, of Orlando, Florida, pleaded guilty on Feb. 29, before U.S. District Judge Michael A. Shipp in Trenton federal court to an information charging him with one count of conspiracy to commit health care fraud.
According to documents filed in the case and statements made in court:
BOSTON—Myomo, Inc. (Myomo or the Company), a wearable medical robotics company that offers increased functionality for those suffering from neurological disorders and upper-limb paralysis, today announced that on February 29, 2024, the Centers for Medicare & Medicaid Services (CMS) posted the final Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedule payment rates for the MyoPro.
SPOKANE, Washington—Vanessa R. Waldref, the United States Attorney for the Eastern District of Washington, announced that Thomas Andrew Webster, M.D., age 51, of Sylvania, Ohio, pled guilty to conspiring to accept kickbacks in connection with a fraudulent telemarketing and medical supply scheme throughout Washington and in other states. District Judge Mary K. Dimke accepted Webster’s guilty plea and set sentencing for June 26 in Spokane, Washington.
ATLANTA—Brett Weiner and Valerie Desalvo have been sentenced on conspiracy charges for their role in buying and selling fraudulent doctors’ orders used to obtain more than $1.5 million in fraudulent payments from Medicare.
ATLANTA—Simon Orobor has been sentenced for conspiring to pay health care kickbacks payments for unnecessary durable medical equipment (DME), resulting in more than $20 million in claims to, and $13 million in payments from, Medicare.
NEWARK, New Jersey—A Florida man was charged in an indictment unsealed today for his role in durable medical equipment (DME) kickback scheme that caused $97 million in losses to Medicare, Attorney for the United States Vikas Khanna announced.