Search for: "Medicare, Medicaid & Medical Suppliers"
Results 241 - 260
of 467
Sorted by Relevance
|
Sort by Date
15 Nov 2011, 6:16 am
In the spring of this year, the Centers for Medicare and Medicaid Services (CMS) released the proposed rules governing Accountable Care Organizations (ACOs) participating in the CMS Shared Savings Program. [read post]
8 Nov 2010, 4:19 am
If CMS or one of its contractors determines that the failure to meet the 12-month deadline was due to a beneficiary being retroactively entitled to Medicare, but a state Medicaid agency recovered the Medicaid payment for the furnished service 6 months after the service was furnished; or 4.CMS or one of its contractors determines that the failure to meet the 12-month deadline was because, at the time the service was furnished, the beneficiary was enrolled, and subsequently… [read post]
Proposed Settlement Agreement Filed in Federal Court Which Could Change SNF and Home Health Coverage
31 Oct 2012, 11:41 am
The proposed settlement, filed in October, includes provisions that would require the Centers for Medicare & Medicaid Services (CMS) to not only revise portions of the Medicare Manuals to clarify that an "improvement" requirement does not exist for medically necessary home health services, but to also educate Medicare contractors and other reviewers on the appropriate standards to apply when reviewing home health services. [read post]
12 Jul 2018, 12:00 pm
It was alleged that the OB/GYN submitted thousands of claims for pelvic floor therapy training services to the Medicare and Medicaid programs that were either never provided, or were otherwise false or fraudulent.IV. [read post]
31 Mar 2020, 9:01 am
CMS is temporarily waiving the Medicare and Medicaid requirements for physicians and non-physician practitioners to be licensed in the state where they are providing services. [read post]
13 Jul 2012, 8:56 am
In announcing the 89 new ACOs that were selected to participate in the Medicare Shared Savings Program, the Centers for Medicare & Medicaid Services explained that participation in an ACO is purely voluntary for providers; that beneficiaries served by ACOs will continue to have free choice about the care they receive and from whom they seek care, without regard to whether a particular provider or supplier is participating in an ACO; and that "studies have… [read post]
2 Apr 2018, 7:37 am
At last estimate, Medicare Administrative Contractors (MACs) processed an estimated 1.2 billion claims on behalf of America’s seniors.[2] As the Medicare program has grown, the Centers for Medicare and Medicaid Services (CMS) has employed a variety of different claims audit mechanisms to better ensure that the Medicare Trust Fund is protected from waste, fraud and abuse. [read post]
12 Sep 2020, 11:46 am
Physicians, testing laboratories and other health care providers and suppliers would then bill a sober home resident’s insurance company (such as Medicare, Medicaid, TriCare, FEHBP, Railroad Retirement or a private payor).[7] Unfortunately, this is where the sober home business model typically runs afoul of state and federal regulatory and statutory requirements. [read post]
9 Mar 2023, 11:20 am
Of these patients, 6 were Medicare beneficiaries and 32 were Medicaid beneficiaries. [read post]
19 Jun 2010, 12:32 am
With our share of this critical new funding, OIG will expand our Medicare and Medicaid investigations, audits, evaluations, enforcement, and compliance activities to support our health care program integrity efforts. [read post]
27 Apr 2018, 1:24 pm
Revamping the Medicare and Medicaid EHR Incentive Programs CMS proposes substantive changes to the Medicare and Medicaid EHR Incentive Programs. [read post]
30 Sep 2019, 2:08 pm
After pulling a sample of paid Medicare FFS claims, the CERT contractor will then contact the responsible health care provider or supplier and request a copy of the medical documentation associated with the claim at issue. [read post]
12 Jul 2018, 12:00 pm
It was alleged that the OB / GYN submitted thousands of claims for pelvic floor therapy training services to the Medicare and Medicaid programs that were either never provided, or were otherwise false or fraudulent.IV. [read post]
16 Jun 2016, 7:17 am
* * * The Anti-Kickback Statute prohibits the knowing and willful payment of any remuneration to induce the referral of services or items that are paid for by a federal healthcare program, such as Medicare, Medicaid or TRICARE. [read post]
13 Oct 2012, 5:32 pm
OIG is concerned that the theft and misuse of medical identifying information, such as beneficiary numbers and provider or supplier numbers, could be used to fraudulently obtain or bill for medical services or supplies. [read post]
21 May 2015, 10:58 am
Code § 3729 Medically Necessary Services A recent publication of the Centers for Medicare and Medicaid Services explains that Medicare-covered services generally are those considered medically reasonable and necessary to the overall diagnosis or treatment of the patient’s condition or to improve a malforming body function. [read post]
15 Mar 2009, 6:37 pm
The MSPA applies to both past and future medical expenses.s Medicare, Medicaid and SCHIP Extension Act of 2007. [read post]
12 Jan 2015, 1:03 pm
The below applies to Physician Self Referral Prohibitions applicable to any physician/entity that accepts any federal dollars such as Medicare/Medicaid. [read post]
6 Sep 2012, 9:29 am
Dresevic and Gustafson spoke on key legal issues impacting radiology providers and suppliers, including new Medicare initiatives, Stark and Anti-Kickback Law, updates from the Office of the Inspector General, and practical tips on compliance issues. [read post]
8 Jun 2010, 5:52 am
The Board is also required to engage in regular consultations with the Medicaid and CHIP Payment and Access Commission. [read post]
