Providers chafing under Medicare Recovery Audit Contractors

Under MMA Section 303 (text towards end of this MLN article), CMS was authorized to roll out a demonstration project in three states, for three years, engaging RACs to review potential overpayments (and underpayments) to Medicare providers and suppliers.  The RAC contracts are permitted to be contingency-based, and they are, reportedly, entirely contingency-fee-based.  (Another side […]

Massachusetts universal health care costs — higher than expected or no?

Last week, after Governor Patrick’s state of the state address, the Boston Globe ran a story by Alice Dembner on the projected increases in costs of the Massachusetts universal health care coverage law.  A Healthy Blog deconstructs the math, concluding that the costs are not as high as the Globe would have us think.  Without […]

New Jersey's Governor's Commission on Rationalizing Health Care Resources issues final report

New Jersey’s Governor Jon Corzine finally got a final report from the commission on rationalizing healthcare resources he created by executive order just over 15 months ago.  Unlike the Berger Commission in the neighboring Empire State (which issued its final report just after the N.J. commission was authorized), the N.J. commission did not recommend specific […]

David Harlow quoted on gainsharing in Medicare Compliance Alert

There’s an article on the latest gainsharing advisory opinions from the OIG in the latest issue of DecisionHealth’s Medicare Compliance Alert (copyright Medicare Compliance Alert 2008, reproduced here by permission).  I’m quoted in there in connection with the pending gainsharing demonstration projects. I’ll go out on a limb here and take issue with the conclusion […]