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For example, Cigna Group agreed to pay $172 million last year to settle a lawsuit filed by the Justice Department over its Medicare Advantage practices for allegedly using in-home health risk ...
Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...
Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.
The Medicare Fraud Strike Force is a multi-agency team of United States federal, state, and local investigators who combat Medicare fraud through data analysis and increased community policing. Launched in 2007, the Strike Force is coordinated by the United States Department of Justice and the Department of Health and Human Services .
Based on the Centers for Medicare and Medicaid Services’ five-star rating system for nursing homes, of the 199 homes examined in Washington, 31, or about 15.6%, have the worst one-star rating ...
Each part of Medicare covers an aspect of substance use disorder treatment. Read more to learn about the costs and what’s covered.
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity.
The Senior Medicare Patrols (SMP) are a group of volunteer organizations funded by the United States Department of Health and Human Services, which educate U.S. senior citizens on how to prevent, detect, and report Medicare and Medicaid fraud, error, and abuse.
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