The 4 private companies that run Medicare's recovery audit program will have their contracts extended through 2015. But it's unclear what types of medical reviews or claims are going to be eligible for auditing.
The 4 private companies that run Medicare's recovery audit program will have their contracts extended through 2015. But it's unclear what types of medical reviews or claims are going to be eligible for auditing.
CGI Federal, Connolly, HealthDataInsights, and Performant Recovery will be able to actively audit hospitals, doctors and other providers for improper Medicare payments through December 31, 2015, CMS said in a contract award notice posted December 24. Additionally, the recovery audit contractors, or RACs, will be allowed to perform administrative and transitional activities through April 30, 2017. That year-and-a-half period allows them to review any last-minute claims and manage the appeals process.
Read more at Modern Healthcare: http://bit.ly/1Bqwre0
Hospital Participation in Medicare ACOs: No Change in Admission Practices and Spending
August 19th 2025Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
Care Quality Metrics in Medicare During COVID-19 Pandemic
August 12th 2025Medicare Advantage outperformed traditional Medicare on clinical quality measures before and during the COVID-19 pandemic; mid-pandemic, however, traditional Medicare narrowed the gap on some in-person screenings.
Read More