AOPA: Unlicensed O&P providers collect billions in Medicare funds
Unlicensed O&P providers collected billions of dollars in Medicare funds from 2007 to 2011 due to a lack of enforcement by the CMS, while licensed providers have faced Medicare recovery audits that are becoming more aggressive, according to a report released this week by AOPA. The study analyzed three states that mandate O&P provider certification and found that 68% of Medicare bills were for devices from noncertified entities. "This means that billions of dollars in payments were made to providers who Congress specifically intended to exclude from eligibility for payments," AOPA said in a statement. Modern Healthcare (free registration)/Vital Signs blog
(9/18), MassDevice.com (Boston)
Medicare competitive bidding is harmful to more than just patients
Medicare competitive bidding is detrimental to patients and the economy and should be replaced with an auction-based system that includes rigorous standards for the quality of products and services, Catherine Burzik, former president and CEO of Kinetic Concepts, writes. The lack of transparency in CMS' decision-making standards, as well as the lack of penalties for winning bidders who cannot provide the devices promised or who provide poor-quality substitutes compound the problem. "It's a potential threat to patients and can lead to increased costs in our healthcare system. With some adjustments, CMS can and should make this right," she writes. MassDevice.com (Boston)
Monthly premiums for millions will be $100 or less after subsidies
Health insurance premiums will cost $100 or less per month, after tax credits and subsidies, for about 6.4 million people eligible to enroll in a plan through a public marketplace, an HHS report says. About 12.4 million residents of states that expanded Medicaid eligibility will also be able to pay either no premium or less than $100 monthly for coverage, according to the report, which is based on census data. USA Today
Breaking news from AOPA
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