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22 Nov 2016, 6:59 am
CMS considers pass-through payments to be amounts that states require to be added to the contracted payment rates between managed care organization and hospitals, physicians, or nursing facilities that are not for a specific service provided to a specific enrollee under the contract (and subject to certain other specifications). [read post]
23 Jan 2017, 4:57 am
As we previously reported, CMS considers pass-through payments to be amounts that states require to be added to the contracted payment rates between managed care organization and hospitals, physicians, or nursing facilities that are not for a specific service provided to a specific enrollee under the contract (and subject to certain other specifications). [read post]
2 Oct 2023, 5:00 am
In the first phase, OIG intends to review activities that occur when the Centers for Medicare & Medicaid Services (CMS) or states initially establish or renew managed care contracts. [read post]
27 May 2022, 3:51 pm
So long as impacted enrollees are unable to access contracted providers or contracted providers cannot provide needed services, MAOs must comply with the special requirements. [read post]
20 Jul 2023, 2:11 pm
On behalf of CMS (Centers for Medicaid & Medicare Services), the National Contract Management Association (NCMA) and the Professional Services Council (PSC) will host a 90-minute virtual industry-led discussion, with our very own Nicole Pottroff as a presenter. [read post]
18 May 2020, 8:48 am
Thus, all medical practice managers and healthcare providers should be aware of CMS’s process of contracting with Uniform Program Integrity Contractors (UPIC’s), private entities hired by CMS to audit providers suspected of fraud. [read post]
17 Feb 2020, 10:48 am
CMS has put on display a proposed rule that would update Medicare Advantage (MA) and Medicare Part D prescription drug benefit policies for contract year 2021 and 2022. [read post]
12 Jan 2024, 9:00 am
During the term of the amendment (January 9, 2024 through March 31, 2027), New York aims to fundamentally reform the way health care services are delivered through its Medicaid program by: Investing in Health Related Social Needs (HRSN) via providers working with Social Care Networks (SCNs) which in turn contract with existing Medicaid managed care ... [read post]
13 Jun 2021, 2:54 pm
NCSC Court Technology Bulletin: “18F, a team within the General Services Administration(GSA), carried out an 11-week Path Analysis on the federal judiciary’s Case Management and Electronic Case Filesc(CM/ECF) system. [read post]
8 Oct 2019, 2:00 pm
(October 8, 2019): On April 16th, 2018, the Department of Health & Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), issued a Final Rule entitled, “Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program. [read post]
23 Apr 2024, 11:05 am
Making good on its promises to enhance oversight of Medicare Advantage (MA) and Medicare Part D plans, the Centers for Medicare and Medicaid Services (CMS) has submitted for public inspection its Contract Year 2025 Final Rule. [read post]
19 Jul 2016, 7:47 am
CMS also urges states to consider negotiating supplemental rebates with manufacturers for some or all of their Medicaid managed care drug claims, although CMS reminds states to determine the impact of such a decision on their contracts with managed care organizations. [read post]
27 Nov 2017, 12:36 pm
CMS has issued a proposed rule to update the Medicare Advantage (MA) program and Part D prescription drug benefit rules for contract year 2019. [read post]
17 Jan 2023, 11:09 am
Part D Medication Therapy Management Program CMS proposes several changes to its medical therapy management (“MTM”) program to reduce eligibility gaps so that more Part D enrollees with complex drug regimens at increased risk of medication therapy problems would be eligible for MTM services. [read post]
11 Dec 2007, 8:27 pm
CMS recently awarded the MAC contract for A/B Jurisdiction 12 to Highmark Medicare Services. [read post]
26 Jun 2018, 7:28 am
This means Medicare Advantage beneficiaries will be provided adult day care services, respite care for caregivers, and in-home assistance with activities like bathing and managing medications. [read post]
2 Oct 2014, 2:39 pm
The RFI does not commit CMS to contracting or making a grant award in this area. [read post]
16 May 2013, 9:01 am
If this price is acceptable to both parties, they execute a contract for construction services, and the construction manager becomes the general contractor. [read post]
5 Feb 2014, 2:46 pm
On January 10, 2014, the Centers for Medicare & Medicaid Services (CMS) proposed significant changes to the Medicare Prescription Drug Benefit (Part D) Program. [read post]
12 Jun 2017, 7:53 am
Ban on nursing home arbitration agreement officially lifted by CMS. [read post]
