The Tax Relief and Health Care Act of 2006 required a national Recovery Audit Contractors (RAC) program. RACs identify improper Medicare payments and refer potential fraud to the Centers for Medicare & Medicaid Services (CMS). The Department of Health and Human Services, Office of Inspector General (“OIG”) completed a study or RACs in August 2013. Their report, Medicare Recovery Audit Contractors and CMS’s Actions to Address Improper Payments, Referrals of Potential Fraud, and Performance, became available on OIG’s website on September 3, 2013. The report identified certain problems in CMS’ oversight of its RACs and predicted the continuation of a high volume of improper payments.
04 Oct 2013Robert White
The CMS website provides the RAC program’s mission “is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments in all 50 states.” Unlike other Medicare contractors, RACs are paid on a contingency basis. Contingency fees are calculated as a percentage of improper payments that are recovered or returned to providers. RACs do not receive these fees until improper payments are recovered or returned.
Despite having strong economic growth, Indonesia falls behind its neighbors in the healthcare sector. Today’s graphic shows where Indonesia ranks in terms hospital bed capacity and the size of the healthcare workforce.
20 May 2013Thomson Reuters
Would you like infographics like this on your website, blog or other social media? Contact us and visit our Reuters Agency blog for insights and discussions on the changing media industry.
By Michele Gershberg, Editor, Health and Pharma News, Americas
The Reuters Health Summit gave investors and executives an in-depth look at how the healthcare industry is preparing for change, from an overhaul of health coverage in the United States to the global effort to track deadly diseases before they take a devastating turn. The Summit from May 6-8 convened some of the world’s top health regulators and investors for a series of exclusive interviews.
For a summary recap report of the 2013 Reuters Health Summit, click here.
Under section 6102 of the Affordable Care Act, on March 23, 2013, skilled nursing facilities (SNFs) and nursing facilities (NFs) are required to have “in operation” compliance and ethics programs that are effective in preventing and detecting criminal, civil and administrative violations.
The ACA identifies eight required elements for compliance and ethics programs. (more…)
On February 11, 2013 the national Health Care Fraud and Abuse Control Program (“HCFAC”) released its annual report for the 2012 fiscal year. The HCFAC program is a U.S. Department of Health and Human Services and U.S. Department of Justice joint program created to combat fraud in health care. 2012 was a record breaking year for health care fraud enforcement.
The HCFAC report indicates that in 2012, the federal government:
recovered $4.2 billion that was improperly obtained from federal health care programs,
convicted 826 defendants of health care fraud-related crimes,
opened 1,131 new criminal health care fraud investigations, and
excluded 3,131 individuals or entities from federal health care programs.
The amount of money invested by PE firms in health and medical services (which include urgent care) rose to almost $4 billion in 2012. Today’s graphic charts the number of deals, the equity invested in health & medical services and the share of healthcare PE deals.
The medical device tax imposes a 2.3% tax on the sale of medical devices, where “taxable medical device” is defined by the FDA in section 201(h) of the Federal Food, Drug and Cosmetic Act, but excludes eyeglasses, contact lenses, hearing aids, and some other devices under the retail exception. The FDA defines medical devices as instruments used to diagnose, mitigate, cure, treat or prevent disease in humans or animals or devices that affect the structure or function of humans or animals. This results in a broad swath of devices subject to taxation from heart implant products and general hospital equipment to tongue depressors. The Obama administration advocates the increased cost to manufacturers is offset by the influx of millions of new healthcare customers. The tax is expected to generate $29 billion in tax revenue over the next 10 years.
Democratic leaders including Rep. Debbie Wasserman Schultz and Obama economic advisor Austan Goolsbee tell Robert Wolf that the economy has made significant progress since President Obama took office. In a Google+ Hangout, the two and other party officials also talk healthcare and women’s issues with the Reuters TV Impact Players host.
Monster online jobs listings in the retail, healthcare, construction and manufacturing sectors have increased, both since the onset of the recession and year-to-date. Today’s graphic shows the change in online job listings by profession.
Some of the most interesting, provocative and salient quotes we heard around the Aspen Ideas Festival today:
03 Jul 2012Thomson Reuters
“Well-off people don’t think the Affordable Care Act has anything to do with them. You are wrong. We’re all going to have electronic records, we will all go to safer hospitals, and we all will have a situation where doctors are better at focusing on chronic illnesses.” — Ezekiel Emanuel, Vice Provost, Global Initiatives & Chair of the Medical Ethics and Health Policy Department, University of Pennsylvania
“Cities are the first social media platform – cities accelerate connectivity.” – Mark Wigley, Dean of Columbia University’s Graduate School of Architecture, Planning and Preservation
“I think the word data is useful because it sounds so unloaded, but actually data is just a word we use to point to a huge thing we have no grasp of that is neither in the world of objects nor the world of images… We are living a life so much stranger than we are willing to acknowledge.” – Mark Wigley
“We’re rapidly moving to the point where a single point narrative is becoming irrelevant and where co-creation, collaboration and interdependent experiences are becoming very relevant.” – Edward Schlosserg, Founder and Principal Designer, ESI Design
“Data visualization is an important mechanism that allows decision makers to gain critical insights and mine and navigate relationships between data sets.” – James Powell, Chief Technology Officer, Thomson Reuters
“The collaborative model is fascinating – allowing a community to take a view of what the data means.” – James Powell