I suggest the Centers for Medicare and Medicaid Services develop a monthly list of patient’s Medicare and/or Medicaid claims activities and send it to patients, physicians, suppliers or providers for verifications. The statement would combine all health care activities and explain what services were provided for a given month. Fraud and Abuse Hotline information will be added to the report so that individuals can ...more »
Revising the Medicare Premium Notice (bill) to make it clear and comprehensive will provide better customer service to beneficiaries and reduce program costs. Currently the notice: (1) doesn’t always show the appropriate timeframe that is being billed (2) doesn’t have the special messages on the front of the notice, it’s on the back (3) doesn’t show the actual monthly premium due. When beneficiaries have questions ...more »
Centers for Medicare and Medicaid Services (CMS) is required by statute to have "Quality Improvement Organization" contractors in every state pursuant to Sections 1152-1154 of the Social Security Act. It is an incredible waste of resources to support These 50 cost-reimbursement type contracts, most of which are automatically renewed without competition. QIOs do not do anything directly to improve quality, but merely ...more »
The Medicare Administrative Contracts (MAC) are the contracts that the Centers for Medicare and Medicaid Services (CMS) use to process claims submitted to Medicare on behalf of the Medicare beneficiaries. CMS has divided the country into 15 MAC regions for processing Medicare Part A and B claims and into 4 MAC regions for processing Durable Medical Equipment claims. Currently, the process used by CMS is that each contract ...more »
CMS/Medicaid Pharmacy : Why don’t we, the government (CMS) open their own mail order pharmacy? The cost difference between the average wholesale price (AWP) and the acquisition cost (AQC) is sometimes 10,000% wide. So the insurance companies and retail pharmacies are buying medications for pennies and selling them to the government (CMS and Medicaid programs) to highly inflated price. Even though the Medicaid programs ...more »
Hello, I would like to suggest that we set up a comprehensive system interface between the Social Security Administration (SSA) and the Centers for Medicare & Medicaid Services (CMS). Right now SSA does have limited access to CMS' records in that we can verify billing, HI/SMI start and stop dates as well as third party and direct remittances from the beneficiary. What we cannot verify is if the beneficiary has utilized ...more »
I would like to suggest office/cubical sharing. We all have laptops and most have blackberries. We could work alternatate shifts (every other week, every 2 weeks, etc) - one in office, another at home. This could save some building rentals, BG&E and phone bills. With Health Care Reform, many new hires are needed with limited space and we currently occupy multiple buildings.
End our (CMS) government contract with Omega travel agency! It costs too much and employees can make their own online travel arrangements at no cost to the Federal Government!!!! Gov-Trip is also too expensive - get a cheaper, more efficient and user friendly system!!!
To help seniors better understand what their health care providers are billing/charging the Medicare program, beneficiaries' Medicare Summary Notices should include plain language about services billed to Medicare by inpatient and outpatient providers. Most seniors do not understand the scientific and medical names of certain diseases and body parts. Therefore, they may not be able to report fraud and abuse. By using ...more »