Thirty-one percent of accountable care organizations (ACOs) qualified for bonuses from the Medicare Shared Savings Program (MSSP) based on their 2015 performance – the highest number to date, according to the Centers for Medicare & Medicaid Services (CMS).
Thirty-five out of 37 Government Accountability Office (GAO) audits reveal that some private Medicare Advantage plans fraudulently billed the federal government, according to data obtained by the Center for Public Integrity (CPI).
In response to insurance companies pulling out of Affordable Care Act (ACA) exchanges, CMS published policy changes to support the insurance companies who have concerns about high-cost enrollees and risk adjustment.
The United States Attorney in Manhattan announced a settlement with a New York hospital group over claims it willfully delayed repayment of more than $800,000 in Medicaid overpayments. The settlement resolves claims under the federal False Claims Act (FCA) and the New York State False Claims Act.