WASHINGTON—An indictment was unsealed in Brooklyn, New York, charging eight defendants for their alleged roles in a scheme to defraud Medicaid of approximately $68 million through the operation of two social adult day cares and a home health care financial intermediary. Through these operations, the scheme involved paying kickbacks and bribes for services that were not provided.
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.
BALTIMORE, Maryland—The Centers for Medicare and Medicaid Services (CMS) announced additional resources and flexibilities are available in response to Hurricane Milton in Florida. CMS is working with the state of Florida and federal partners to put these flexibilities in place in an effort to ensure those affected by this natural disaster have access to the care they need.
WASHINGTON—Vice President Kamala Harris announced a proposed Medicare at Home benefit designed to help families with caregiving needs and strengthen Medicare. Under the plan, Medicare would cover homecare for the nations’ seniors and those with disabilities who are enrolled in Medicare, as well as vision and hearing benefits aimed at helping seniors live independently for longer.
BALTIMORE, Maryland—The Centers for Medicare and Medicaid Services (CMS) released a report on its study of the acute hospital care at home (AHCAH) initiative, which allows certain Medicare-certified hospitals to treat patients with inpatient-level care at home. While the initiative was launched during the COVID-19 public health emergency, the Consolidated Appropriations Act of 2023 (CAA) extended the waivers and flexibilities associated with the AHCAH initiative until Dec. 31, 2024.
BALTIMORE—The Centers for Medicare and Medicaid Services (CMS) has released the first draft of its hospice outcomes and patient evaluation (HOPE) tool, a new assessment tool for hospices. The HOPE tool was developed to replace the hospice item set (HIS) as part of the hospice quality reporting program (HQRP).
ALEXANDRIA, Virginia—The National Home Infusion Association (NHIA), a trade association representing infusion companies and providers, commented on a proposed rule on Medicare home health (HH) programs from the Center for Medicare and Medicaid Services (CMS).
WASHINGTON—The Centers for Medicare and Medicaid Services (CMS) issued a final rule in response to reports of alleged catheter fraud.
BALTIMORE, Maryland—The Centers for Medicare and Medicaid Services (CMS) announced additional resources and flexibilities available in Florida and Georgia in response to Hurricane Helene. CMS is working closely with the states of Florida and Georgia to put these flexibilities in place, ensuring those affected by this natural disaster have access to the care they need.
WASHINGTON—The Partnership for Quality Home Healthcare (PQHH), a coalition of Medicare home health providers aiming to increase access to quality homecare, released a third-party analysis of Medicare home health fee-for-service claims from 2022 through 2023, which found a decline in access to home health services for patients and families.
WASHINGTON—Congressman Earl Blumenauer (D-OR), a senior member of the Ways and Means Committee, introduced the Hospice Care Accountability, Reform and Enforcement Act (Hospice CARE Act) in an effort to modernize Medicare’s hospice benefit, which has remained largely unchanged since its inception in 1982.
WATERLOO, Iowa—Leitten Consulting has released a comprehensive report highlighting the critical need for Medicare to shift its focus from competitive bidding to proactive investment in durable medical equipment (DME). The report, authored by Brian Leitten, underscores the cost savings and health benefits of providing timely DME to Medicare beneficiaries.
WASHINGTON—The House passed 14 new bipartisan health bills. The following bills were passed out of the House Energy and Commerce Committee and passed the House unanimously.
WASHINGTON—The Center for Medicare & Medicaid Services (CMS) recovered Medicare payments to providers under the COVID-19 Accelerated and Advance Payment (CAAP) programs in compliance with federal requirements, according to an audit conducted by the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG).
ARLINGTON, Virginia—The American Association for Homecare (AAHomecare) announced it will be holding webinars on the topics of home medical equipment (HME), e-prescribing strategies, durable medical equipment (DME) suppliers and billing in October. The details of the webinars are listed below.
MINNEAPOLIS—Tactile Systems Technology Inc., a medical technology company providing therapies for people with chronic disorders, has been approved by the pricing, data analysis and coding (PDAC) contractor for the Centers for Medicare & Medicaid Services (CMS) for the use of health care common procedure coding system (HCPCS) code E0651 for billing the durable medical equipment Medicare administrative contractors for its pneumatic compression platform, “Nimbl.”
SALT LAKE CITY—Matia Mobility, a durable medical equipment company, has been granted a health care common procedure coding system (HCPCS) code for their “Tek” robotic mobilization device (RMD) by the Centers for Medicare & Medicaid Services (CMS).
WILMINGTON, Delaware—Dr. Vishal Patel, a Wilmington physician, has agreed to pay $1 million to resolve allegations of violating the False Claims Act by ordering medically unnecessary durable medical equipment (DME) for patients covered by Medicare and the Federal Employees Health Benefits Program (FEHBP), announced U.S. Attorney David Weiss.
BALTIMORE, Maryland—The Centers for Medicare & Medicaid Services (CMS) announced additional resources and flexibilities are available in response to Hurricane Francine in Louisiana. CMS is working closely with the state of Louisiana to put these flexibilities in place to ensure those affected by the natural disaster have access to the care they need.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) and Wisconsin Physicians Service Insurance Corporation (WPS), a CMS contractor, notified nearly one million individuals whose protected health information or other personally identifiable information (PII) may have been compromised in connection with Medicare administrative services provided by WPS.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) posted its final notice for Transitional Coverage for Emerging Technologies (TCET) on Aug. 7.
FRANKLIN, Tennessee—Kythera Labs, Inc. announced its certification as a Qualified Entity from the Centers for Medicaid & Medicare Services (CMS). The CMS Qualified Entity (QE) Program, also known as the Medicare Data Sharing for Performance Measurement Program, enables certified organizations to receive Medicare claims data under Parts A, B and D. Only 39 organizations are QEs and only 23, including Kythera, have access to nationwide data.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) announced additional resources and flexibilities available in response to Hurricane Debby, now Tropical Storm Debby, in the states of Florida, Georgia and South Carolina. CMS is working closely with these states to ensure those affected by this natural disaster have access to the care they need—when they need it most.