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The Centers for Medicare & Medicaid Services (CMS) is planning a potentially-significant overhaul of Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its proposed annual DMEPOS policy update for calendar year (CY) 2020. [read post]
13 Aug 2019, 1:28 pm by Robert Liles
(August 12, 2019):  Over the last year, a number of genetic testing fraud investigations and prosecutions have been initiated by Medicare, Medicaid and TRICARE investigators and auditors. [read post]
30 Jul 2019, 12:17 pm by Thomas Dowdell (US)
On July 29, the Centers for Medicare & Medicaid Services (CMS) published three proposed rules for Calendar Year (CY) 2020: Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule; Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule (MPFS); and End State Renal Disease (ESRD) and Durable Medical Equipment Prosthetics, Orthotics and… [read post]
16 Jul 2019, 2:01 pm by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
10 Jul 2019, 3:33 pm by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
15 Jun 2019, 9:00 am by Staff
Medical practices that rent, for example, to a durable medical equipment supplier, raise a concern because the durable medical equipment suppliers are likely to benefit from referrals of the medical practice’s patients. [read post]
29 May 2019, 2:06 am by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
9 May 2019, 8:06 am by Cynthia Marcotte Stamer
On Wednesday, May 8, 2019, Health and Human Services(“HHS”) Secretary Alex Azar announced the adoption of a Medicare and Medicaid Programs; Regulation to Require Drug Pricing Transparency Final Rule (the “Rule”) by the Centers for Medicare & Medicaid Services (“CMS”) requiring direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or Medicaid to include the list… [read post]
8 May 2019, 2:12 pm by Debra A. McCurdy
Medical equipment suppliers can submit bids for Round 2021 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) from July 16 through September 18, 2019, the Centers for Medicare & Medicaid Services (CMS) has just announced. [read post]
8 May 2019, 12:44 pm by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
6 May 2019, 5:44 pm by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
1 May 2019, 4:39 am by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
30 Apr 2019, 10:23 am by Cynthia Marcotte Stamer
Health plans must deliver electronic protected health information (“ePHI”) to electronic applications or software (“apps”) used by plan members, and are responsible under the Health Insurance Portability & Accountability Act (“HIPAA”) Privacy and Security Rules for the security of electronic protected health information (“ePHI”) on apps they sponsor or provide, according to new guidance from the Department of Health & Human Services… [read post]
29 Apr 2019, 7:21 am by Cynthia Marcotte Stamer
A Wisconsin employer did not violate the National Labor Relations Act (“NLRA”) by ceasing to deduct union dues from employees’ paychecks for remittance to their certified union in response to Wisconsin’s enactment of a right-to-work law that curtailed dues checkoff, or communicating with employees about this action according the National Labor Relations Board ruling in Metalcraft of Mayville, Inc. [read post]
27 Mar 2019, 8:13 am by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
27 Mar 2019, 6:24 am by Cynthia Marcotte Stamer
Adding employee recess to the workday schedule could be a cost effective wellness tool based on recently health research recently reported by the National Institutes on Health (“NIH”). [read post]
”  This summary focuses on the major Medicare and Medicaid proposals most directly impacting providers and suppliers; note that we discuss the Administration’s proposed prescription drug reimbursement provisions in a separate blog post. [read post]
26 Mar 2019, 10:24 am by Cynthia Marcotte Stamer
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and… [read post]
20 Mar 2019, 7:24 am by Cynthia Marcotte Stamer
  Many employees or other individual taxpayers also do not realize that different deduction rates apply to businesses versus charitable and medical mileage expenses. [read post]