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Medical practices that want to protect their patients should pay close attention to fraudsters looking to make major, illegal dollars off Medicare in 2020. Officials warn that scams tend to escalate when health care is in the news, and since 2020 is an election year, you can expect an increase in scammers seeking to raid Medicare accounts.

The Direct Contracting (DC) demonstration model that CMS is rolling out brings some free-market features to Medicare, letting practices negotiate with providers on how much of the capitated payments they’ll receive. Experts think this represents a trend in CMS’ approach to value-based care.


Heads up: CMS, tipped off by OIG, is warning providers who do sleep studies to make sure they have appropriate documentation and don’t botch the billing of technicians.


While sleep studies and continuous positive airway pressure (CPAP) devices are getting more popular, Medicare billing for them so far has held pretty steady. But as the tough denial rates for a major CPAP code show, you still have to be careful about billing them.


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