Posts Tagged ‘Marilyn Tavenner’

CMS Imposes First Affordable Care Act Enrollment Moratoria to Combat Fraud

July 26, 2013

Building on strong anti-fraud efforts already underway, Centers for Medicare & Medicaid Services’ Administrator Marilyn Tavenner today announced temporary moratoria on the enrollment of new home health provider and ambulance supplier enrollments in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP) in three fraud “hot spot” areas of the country, including two Florida counties. The goal of the temporary moratoria is to fight fraud and safeguard taxpayer dollars, while ensuring patient access to care. Authority to impose such moratoria was included in the Affordable Care Act, and CMS is exercising this authority for the first time.

Under the moratoria, existing providers and suppliers can continue to deliver and bill for services, but no new provider and supplier applications will be approved in these areas for all three programs. The temporary enrollment moratoria apply to newly-enrolling home health agencies in the Miami and Chicago metropolitan areas; and newly-enrolling ground ambulance suppliers in the Houston metropolitan area (see list of affected counties below). CMS announced the temporary, six-month moratoria in a notice issued today in the Federal Register. (more…)

Medicare Urges Seniors to Join the Fight Against Fraud

June 6, 2013

In mailboxes across the country, people with Medicare will soon see a redesigned statement of their claims for services and benefits that will help them better spot potential fraud, waste and abuse. These newly redesigned Medicare Summary Notices are just one more way the Obama Administration is making the elimination of fraud, waste and abuse in health care a top priority. Because of actions like these and new tools under the Affordable Care Act, the number of suspect providers and suppliers thrown out of the Medicare program has more than doubled in 35 states. (more…)

Marilyn Tavenner Approved by the Senate to Lead CMS in a 91-7 Vote

May 17, 2013

Marilyn Tavenner, the acting head of the Centers for Medicare and Medicaid Services (CMS), was approved to become the agency’s official Administrator on a 91-7 vote on Wednesday night. The vote comes after Ms. Tavenner’s unanimous approval – by voice vote – in the Senate Finance Committee late last month, and after Senator Tom Harkin (D-IA) lifted his hold on her appointment because of a dispute with the Obama Administration about funds for preventive health services being diverted to help fund the implementation of the Affordable Care Act. (more…)

Two Florida HHAs Selected by CMS for Initiative to Improve Care and Reduce Medicare Costs

February 1, 2013

Hundreds of Providers Selected to Participate in the Bundled Payments for Care Improvement Initiative

This week, the Centers for Medicare & Medicaid Services announced that over 500 organizations will begin participating in the Bundled Payments for Care Improvement initiative. Through this new initiative, made possible by the Affordable Care Act, CMS will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

“The objective of this initiative is to improve the quality of health care delivery for Medicare beneficiaries, while reducing program expenditures, by aligning the financial incentives of all providers,” said Acting Administrator Marilyn Tavenner. (more…)

OIG Pressures CMS on Home Health Sanctions

May 23, 2012

As the number of home health agencies and fraud cases related to home health agencies continues to skyrocket, the Office of Inspector General (OIG) is exerting more pressure on the Centers for Medicare & Medicaid Services (CMS) to fulfill an obligation that is 15 years old.

Back in 1987, the Omnibus Budget Reconciliation Act (OBRA) directed CMS to implement intermediate sanctions for noncompliant home health agencies (HHAs). OBRA specified that the intermediate sanctions CMS created should include civil money penalties, payment suspension and appointment of temporary management. While there is a corrective process for noncompliant HHAs, the only HHA sanction option CMS currently has at its disposal is termination, an option it doesn’t use often. (more…)

HHS Announces New Affordable Care Act Options for Community-Based Care

April 30, 2012

New opportunities in Medicaid and Medicare that will allow people to more easily receive care and services in their communities rather than being admitted to a hospital or nursing home were announced today by Health and Human Services Secretary Kathleen Sebelius.

HHS finalized the Community First Choice rule, which is a new state plan option under Medicaid, and announced the participants in the Independence At Home Demonstration program. The demonstration encourages primary care practices to provide home-based care to chronically ill Medicare patients.

Both are made possible by the Affordable Care Act. Studies have shown that home- and community-based care can lead to better health outcomes. (more…)

CMS News: Consumers Can Now Compare Results from HHAs’ Patient Surveys

April 19, 2012

CMS to publicly report on consumer experiences with Medicare-certified home health agencies

Results from the Centers for Medicare & Medicaid Services’ (CMS) national survey that asks patients about their experiences with Medicare-certified home health agencies are now available on the agency’s Quality Care Finder website. (more…)

CMS Announces Three New Accountable Care Organizations in Florida

April 11, 2012

Three out of the first 27 accountable care organizations (ACOs) in CMS’ new Shared Savings Program reside in Florida and will be online with its counterparts from across the country this month.

According to a press release by CMS, “The selected organizations have agreed to be responsible for improving care for nearly 375,000 beneficiaries in 18 states through better coordination among providers.”

The CMS statement continues that all ACOs that succeed in providing high quality care may share in the savings to Medicare, as long as their performance reduces the cost of care and is sufficiently rated on 33 quality measures. The quality measures relate to, among other things, care coordination and patient safety, use of appropriate preventive health services, improved care for at-risk populations, and the patient experience of care. (more…)

Congressman Urges Feds to Investigate Medicare Fraud in Houston

March 9, 2012

The Houston Chronicle reported today that the chairman of a powerful congressional oversight committee has called for investigations by three federal agencies into ongoing Medicare fraud in the Houston region in which home health care agencies have cheated taxpayers out of tens of millions of dollars.

U.S. Rep. Charles Boustany Jr., R-La., said repeated testimony before a House Ways and Means subcommittee in early 2011 documented concerns about Medicare billing and yet, “Nearly a year later, recent reports out of Texas suggest … providers continue to operate with impunity.” (more…)

Medicare Proposes New Steps to Protect Taxpayer Dollars

February 15, 2012

The Centers for Medicare & Medicaid Services (CMS) yesterday proposed that providers and suppliers must report and return self-identified overpayments either within 60 days of the incorrect payment being identified, or on the date when a corresponding cost report is due – whichever is later.

The new announcement is one in a series of steps Medicare is taking to protect taxpayer dollars, including efforts to prevent overpayments from occurring. These efforts include letting private auditors working on behalf of Medicare catch wasteful spending before it happens, by expanding the use of Recovery Audit Contractors; testing changes to outdated hospital billing system to help prevent over-billing; and changing processes for approving payments for medical equipment with high error rates. (more…)