Convicted assisted living owner blasted: ‘He has no respect for the law’
By
John O'Connor
Nov 25, 2019
Philip Esformes had an expensive Thursday. That’s because the senior living operator was ordered to pay $44.2 million for his role in a $1.3 billion healthcare fraud scheme.
Regulators warned to curb fraud and abuse more aggressively
By
John O'Connor
May 25, 2016
The Centers for Medicare & Medicaid Services came under withering criticism this week for allegedly failing to target fraud and waste. The latest salvos were delivered during a House subcommittee hearing,...
Hospice sector assails double-digit payment cuts
By
John O'Connor
Dec 10, 2019
The hospice sector quickly blasted a 20% Medicare payment cut proposed by a congressional advisory panel.
House budget takes aim at health spending
By
John O'Connor
Mar 17, 2016
House Republicans unveiled a 2017 spending blueprint Tuesday that dramatically trims outlays for Medicare, Medicaid and other other health services by more than $1 trillion over the next decade.
Did Nancy Pelosi just kill Medicare for All?
By
John O'Connor
Nov 04, 2019
House Speaker Nancy Pelosi on Friday panned a Medicare for All proposal being forwarded by a number of Democrats currently running for president. Her implicit suggestion to fellow Democrats: Stick with...
House Democrats crafting plan to reduce Medicare drug costs
By
John O'Connor
Sep 11, 2019
A plan being hatched by House Democratic leaders would allow the Department of Health and Human Services to negotiate prices for up to 250 Medicare-covered medications, as well as insulin.
Caught in a Medicare claims appeals case? You may not have to immediately turn over disputed funds.
By
John O'Connor
Apr 06, 2018
Senior living firms engaged in a Medicare claims appeal currently are required to return any disputed payments right away. A recent court ruling, however, gives operators a chance to retain disputed amounts...
Insurers likely to add and trim senior living benefits, thanks to relaxed Medicare rule
By
John O'Connor
Apr 06, 2018
Medicare managed care enrollees soon may enjoy enhanced senior living benefits, thanks to a new rule. But existing coverage also may be reduced or eliminated when revamped policies hit the marketplace,...
Beneficiaries often reluctant to change Medicare or drug coverage, report finds
By
John O'Connor
Dec 13, 2019
In theory, beneficiaries in private Medicare Advantage plans and Part D stand-alone prescription drug plans could be switching plans each year. But as a new Kaiser Family Foundation report shows, that...
CMS needs to improve handling of beneficiary data, GAO says
By
John O'Connor
May 13, 2018
The Centers for Medicare & Medicaid Services needs to improve how it handles shared beneficiary data, according to the Government Accountability Office.