Risk Adjustment & Payment
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Novitas Improperly Paid Millions for Medicare Part B Services for Nursing Home Patients
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New maternal billing codes should create a transparent system where both patients and clinicians can thrive, ACOG writes.
CMS finalizes 2.3% hospital pay bump, mandatory joint replacement model: 9 things to know
New data on No Surprises Act IDR cases show providers won often in 2025
Providers and their intermediaries continued to flourish in the No Surprises Act’s independent dispute resolution (IDR) process during the second half of 2025, according to newly released data from th...
CMS finalizes 2.3% hospital pay bump, mandatory joint replacement model: 9 things to know - beckerspayer.com
CMS finalizes 2.3% hospital pay bump, mandatory joint replacement model: 9 things to know beckerspayer.com
Healthcare exec, telemedicine company owner sentenced for $35M DME fraud scheme
Two Florida men have been sentenced to federal prison for their roles in a scheme that submitted approximately $35 million in fraudulent Medicare Advantage claims for medically unnecessary orthotic br...
Healthcare Executive and Telemarketing Company Owner Sentenced to Prison for Exploiting Elderly Medicare Advantage Beneficiaries in $35 Million Fraud Scheme - Office of Inspector General (.gov)
Healthcare Executive and Telemarketing Company Owner Sentenced to Prison for Exploiting Elderly Medicare Advantage Beneficiaries in $35 Million Fraud Scheme Office of Inspector General (.gov)
Texas Laboratory, Former CEO, and Florida Businessman Pay a Total of $36.4M to Settle Allegations of Kickbacks and Unnecessary Genetic Testing - Office of Inspector General (.gov)
Texas Laboratory, Former CEO, and Florida Businessman Pay a Total of $36.4M to Settle Allegations of Kickbacks and Unnecessary Genetic Testing Office of Inspector General (.gov)