Search for: "Medicare, Medicaid & Medical Suppliers"
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25 Feb 2020, 3:00 pm
Expansion of the durable medical equipment (DME), prosthetics, orthotics, and supplies competitive bidding program to all geographic areas and to inhalation drugs, payment of contract suppliers based on their own bids, and elimination of the surety bid bond requirement [$7.73 billion Medicare savings, $435 million in Medicaid savings]. [read post]
3 Feb 2020, 8:21 am
Defined benefit and other plan sponsors, fiduciaries, administrators, and their legal counsel and other service providers should review a new Pension Benefit Guarantee Final Regulation on Miscellaneous Corrections, Clarifications, and Improvements scheduled for publication tomorrow (February 4, 2020) that will make various key changes to the PBGC’s current regulations on n Reportable Events and Certain Other Notification Requirements, Annual… [read post]
28 Jan 2020, 9:58 pm
A specialized medical-records provider that contracts with healthcare suppliers nationwide to maintain, retrieve, and produce individuals’ PHI, Cox handles tens of millions of requests for records containing PHI annually including demands by healthcare providers for treatment purposes, patients asking for their own PHI, and third parties, such as life insurance companies and law firms, seeking a patient’s PHI for commercial or legal reasons. [read post]
27 Jan 2020, 5:38 pm
* * *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]
23 Jan 2020, 3:16 pm
Philip Esformes of Miami Beach, Florida, was sentenced to 20 years in prison for his role in a decades-long $1.3 billion fraud scheme to submit fraudulent claims to Medicare and Medicaid both for services deemed medically unnecessary and services that were medically necessary but that he did not provide. [read post]
1 Jan 2020, 10:35 am
While not topping this record, OCR during 2019 now has collected civil monetary penalties and resolution payments totaling more than $15 million from HIPAA Covered Entities and their business associates including: A $3 Million Resolution Payment from Cottage Health; A $3 Million Resolution Payment From A Tennessee Diagnostic Medical Imaging Services Company; A $100,000 Resolution Payment From An Indiana Medical Records Service Business Associate;… [read post]
18 Dec 2019, 10:03 am
By dispensing drugs without valid prescriptions, Omnicare presented, or caused to be presented, hundreds of thousands of false claims to Medicare, Medicaid, and TRICARE that were ineligible for payment in violation of the False Claims Act. [read post]
16 Dec 2019, 3:13 pm
OCR’s investigation determined that, in addition to that impermissible disclosure, DADS violated the HIPAA Security Rule by failing to conduct an enterprise-wide risk analysis and implement access and audit controls on Community Living Assistance and Support Services and Deaf Blind with Multiple Disabilities (“CLASS/DBMD”) program information systems and applications intended to collect and report information about “Utilization Management and Review” activities… [read post]
10 Dec 2019, 4:02 pm
According to the report, private health insurance, Medicare, and Medicaid experienced faster growth in 2018. [read post]
7 Dec 2019, 9:54 am
This involvement encompasses helping health care systems and organizations, group and individual health care providers, health plans and insurers, health IT, life sciences and other health industry clients prevent, investigate, manage and resolve sexual assault, abuse, harassment and other organizational, provider and employee misconduct and other performance and behavior; manage Section 1557, Civil Rights Act and other discrimination and accommodation, and other regulatory, contractual and other… [read post]
14 Nov 2019, 11:00 am
The Centers for Medicare & Medicaid Services (CMS) is seeking public input on surveys that are intended to “further strengthen the monitoring, outreach, and enforcement functions” of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program – even though the agency has asserted that the program “has maintained beneficiary access to quality products from accredited… [read post]
4 Nov 2019, 11:51 am
On October 31, 2019, the Centers for Medicare & Medicaid Services (CMS) released its final rule with comment period that sets forth updates to the home health prospective payment system (HH PPS) for calendar year (CY) 2020 and includes other policy changes for home health agencies (HHA). [read post]
1 Nov 2019, 3:47 pm
The Centers for Medicare & Medicaid Services (CMS) has adopted — with limited changes — its controversial plan to rewrite Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its annual DMEPOS policy update for calendar year (CY) 2020. [read post]
16 Oct 2019, 2:33 pm
—On or after the date of implementation determined by the Secretary under subparagraph (C), a provider of medical or other items or services or supplier within a particular industry sector or category shall, as a condition of enrollment in the program under this title [Medicare], title XI [read post]
14 Oct 2019, 3:33 pm
” “A physician practice could provide smart pillboxes to patients without charge to help them remember to take their medications on time. [read post]
9 Oct 2019, 3:23 pm
In response, on June 25, 2018, the Centers for Medicare & Medicaid Services (CMS) published a Request for Information seeking input on how it could address existing Stark Law barriers to these emerging value-based payment and delivery systems. [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]
18 Sep 2019, 2:08 pm
Medicare, Medicaid and CHIP Enrollment Revocation and Denial Authorities Have Expanded. [read post]
18 Sep 2019, 2:08 pm
Medicare, Medicaid and CHIP Enrollment Revocation and Denial Authorities Have Expanded. [read post]
17 Sep 2019, 1:21 pm
A Civil Investigative Demand Issued to You or Your Medical Practice is Serious Business. [read post]
