Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries who Received Services During 2009 Through 2011 PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries who Received Services During 2009 Through 2011 PDF full book. Access full book title Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries who Received Services During 2009 Through 2011 by . Download full books in PDF and EPUB format.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
Pursuant to Title XVIII of the Social Security Act, the Medicare program provides health insurance for people aged 65 and over, people with disabilities, and people with permanent kidney disease. The Centers for Medicare & Medicaid Services (CMS), which administers the program, contracts with Medicare contractors to process and pay Medicare Part A and Part B claims submitted by health care providers. Under Federal requirements, Medicare generally does not pay for services rendered to incarcerated beneficiaries. Federal requirements, however, allow Medicare payment if State or local law requires incarcerated beneficiaries to repay the cost of medical services. Health care providers indicate this exception by placing a specific code on the claims submitted for payment. We refer to this code as "exception code." The Social Security Administration (SSA) is CMS's primary source of information about incarcerated beneficiaries. Generally, SSA collects information, such as the names of beneficiaries and the dates on which beneficiaries begin and/or end periods of incarceration, directly from penal authorities. SSA also collects incarceration end dates from beneficiaries' requests for reinstatement of Social Security benefits. CMS's records identified 135,805 Medicare beneficiaries who had been incarcerated at some point during calendar years (CY) 2009 through 2011. We limited our review to 75,639 claims on behalf of 11,619 incarcerated beneficiaries with $33,587,634 in associated Medicare payments.
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
Pursuant to Title XVIII of the Social Security Act, the Medicare program provides health insurance for people aged 65 and over, people with disabilities, and people with permanent kidney disease. The Centers for Medicare & Medicaid Services (CMS), which administers the program, contracts with Medicare contractors to process and pay Medicare Part A and Part B claims submitted by health care providers. Under Federal requirements, Medicare generally does not pay for services rendered to incarcerated beneficiaries. Federal requirements, however, allow Medicare payment if State or local law requires incarcerated beneficiaries to repay the cost of medical services. Health care providers indicate this exception by placing a specific code on the claims submitted for payment. We refer to this code as "exception code." The Social Security Administration (SSA) is CMS's primary source of information about incarcerated beneficiaries. Generally, SSA collects information, such as the names of beneficiaries and the dates on which beneficiaries begin and/or end periods of incarceration, directly from penal authorities. SSA also collects incarceration end dates from beneficiaries' requests for reinstatement of Social Security benefits. CMS's records identified 135,805 Medicare beneficiaries who had been incarcerated at some point during calendar years (CY) 2009 through 2011. We limited our review to 75,639 claims on behalf of 11,619 incarcerated beneficiaries with $33,587,634 in associated Medicare payments.
Author: Publisher: ISBN: Category : Languages : en Pages : 14
Book Description
Individuals who are incarcerated in correctional facilities (incarcerated beneficiaries) are generally not eligible for Federal health care benefits. We are conducting a series of reviews of Medicare payments for services provided to incarcerated beneficiaries. We previously reported that Medicare made improper Part A and Part B payments totaling $33.6 million to health care providers for services provided to incarcerated beneficiaries. This is a review of payments made on behalf of incarcerated beneficiaries in Medicare Part D. The objective of this review was to determine the extent to which the Centers for Medicare & Medicaid Services (CMS) accepted prescription drug event (PDE) records submitted by sponsors for prescription drugs provided to incarcerated beneficiaries during calendar years (CYs) 2006 through 2010.
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations Publisher: ISBN: Category : Medicare Languages : en Pages : 164
Author: Office, U.s. Government Accountability Publisher: ISBN: 9781974623396 Category : Languages : en Pages : 30
Book Description
"GAO has designated Medicare as a high-risk program because of its size, complexity, and susceptibility to improper payments. In 2010, Medicare covered 47 million elderly and disabled beneficiaries and had estimated outlays of $516 billion. The Centers for Medicare & Medicaid Services (CMS) is the agency in the Department of Health and Human Services (HHS) responsible for administering the Medicare program and leading efforts to reduce Medicare improper payments.This testimony focuses on estimated improper payments in the Medicare program for fiscal year 2010 and the status of CMS's efforts to implement key strategies to help reduce improper payments. This testimony is primarily based on previous GAO reporting related to governmentwide improper payments, Medicare high-risk challenges and program integrity efforts, and CMS's information technology systems intended to identify improper payments. GAO supplemented that prior work with additional information on the nature and extent of Medicare improper payments reported by HHS in its fiscal year 2010 agency financial report. GAO also received updated information from CMS in February 2011 and, in select cases, as of July 2011, on its actions related to relevant laws, regulations, guidance, and open recommendations pertaining to..."
Author: Aspen Health Law Center Publisher: ISBN: Category : Business & Economics Languages : en Pages : 156
Book Description
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309459575 Category : Medical Languages : en Pages : 483
Book Description
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Author: National Academies of Sciences Engineering and Medicine Publisher: ISBN: 9780309685061 Category : Languages : en Pages :
Book Description
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309486483 Category : Medical Languages : en Pages : 175
Book Description
The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already existâ€"like evidence-based medicationsâ€"are not being deployed to maximum impact. To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.
Author: 
Author: 
Author: 
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations
Author: Office, U.s. Government Accountability
Author: Aspen Health Law Center
Author: National Academies of Sciences, Engineering, and Medicine
Author: National Academies of Sciences Engineering and Medicine
Author: National Academies of Sciences, Engineering, and Medicine
Author: United States. Government Accountability Office
Author: Texas