Hospitals In 7 States Pay Nearly $15.7M To Settle Psychiatric Billing Claims
The payments were to settle Justice Department allegations that the providers billed Medicare for psychiatric services that were not medically necessary. And an analysis finds that more than half of Medicare payments are still tied to the volume of services delivered rather than to their value.
The Associated Press:
16 Hospitals To Pay Nearly $15.7M To Settle Claim
The U.S. Department of Justice says 16 hospitals in seven states and their corporate parents have agreed to pay nearly $15.7 million to settle allegations they violated the False Claims Act by receiving Medicare reimbursements for psychiatric services that were not "medically reasonable or necessary." Health Management Associates Inc. and 14 of its hospitals in Arkansas, Oklahoma, Mississippi, Texas, North Carolina, Georgia and Florida will pay a total of $15 million. Community Health Systems and its subsidiary Wesley Medical Center in Mississippi will pay $210,000; and North Texas Medical Center in Texas will pay $480,000. (5/7)
Reuters:
Sixteen Hospitals To Pay $15.69M To Resolve U.S. Psychiatric Care Probe
Sixteen hospitals will pay $15.69 million to resolve allegations they were reimbursed from Medicare for services that were unnecessary, the U.S. Justice Department said on Thursday. They are alleged between 2005 and 2013 to have billed for mental health treatments that they knew did not meet the standard for Medicare reimbursement, including providing substandard therapy, the department said. (Dunsmuir, 5/7)
California Healthline:
Scorecard: Less Than Half Of Medicare Payments Tied To Value
A scorecard on Medicare payment reform released this week shows progress in transforming Medicare into a results-oriented payer of health services, but there is much ground left to cover, according to the report. (Vesely, 5/7)
Meanwhile, a presidential campaign revives talk of reforming entitlement spending -
The New York Times:
2016 Politics Drive Talk On Entitlements
Social Security and Medicare consume more than 40 percent of federal spending. The trustees of the programs, beseeching lawmakers to shore up their finances, project that they will swell to 11.5 percent of the entire economy within 20 years, compared with 8.4 percent in 2013. Yet the debate in Washington has been frozen since President Obama and the House speaker, John A. Boehner, failed to strike a “grand bargain” on tax and spending levels. (Harwood, 5/7)