Search for: "CMS CONTRACT MANAGEMENT SERVICES"
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12 Feb 2015, 1:07 pm
The latest report highlights five areas of particular concern to the GAO: Payments and provider incentives in original Medicare (specifically referencing physician feedback reports, physician self-referral policy, high-expenditure Part B drugs, end stage renal disease (ESRD) bundled payments, and low-volume payment adjustments for dialysis facilities); Medicare Advantage (MA) and other Medicare health plans (including concerns about MA plan payment adjustments and excess payments to… [read post]
16 Sep 2019, 11:50 am
An interest in which an individual or entity exercises operation of managerial control over, or directly or indirectly conducts, the day-to-day operations of another organization either under contract or other arrangement, regardless of whether or not the managing individual or entity is a W-2 employee of the organization. [read post]
13 Dec 2022, 11:58 am
PCS and HHCS services subject to EVV requirements are very broad: all services requiring an in-home visit that are included in claims under the PCS or HHCS categories on the Centers for Medicare & Medicaid Services (CMS) Form-64 must comply with EVV requirements, even if they are bundled into different services or furnished through a managed care provider. [read post]
9 Jul 2015, 3:28 pm
On July 8, 2015, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule containing major provisions relating to the Physician Self-Referral Law (i.e., the Stark Law) and its exceptions. [read post]
15 Mar 2020, 3:21 pm
The Centers for Medicare and Medicaid Services (CMS) has announced a new voluntary Part D Senior Savings Model (the Model) intended to reduce Medicare beneficiary cost sharing for insulin. [read post]
27 May 2021, 5:04 am
On May 11, 2021, the Centers for Medicare & Medicaid Services (CMS) of the U.S. [read post]
10 Apr 2018, 6:38 am
The final rule states that CMS will integrate drug management programs with the Overutilization Monitoring System (OMS) and Part D Opioid Utilization Review Policy. [read post]
15 Mar 2012, 4:45 pm
In turn Fisher Engineering had contracted CM Structural Services Ltd to erect the steelwork. [read post]
22 Apr 2013, 12:51 pm
The Director of CMS is directed to make that determination based on the actual cost of medical services adjusted for age, sex and geographic and demographic characteristics. [read post]
13 Sep 2021, 1:33 pm
” The Task Force’s guidance must then be approved by the Director of the Office of Management and Budget. [read post]
18 Feb 2008, 11:49 am
There are some that haven't, and I hope CMS will cancel their contracts. [read post]
23 Nov 2020, 3:51 pm
Additionally, the final rule modifies the following existing AKS safe harbors: Local transportation; Warranties; Electronic health records arrangements; and Personal service and management contracts. [read post]
8 Apr 2013, 9:30 pm
Whereas under standard Medicare, the federal government reimburses Medicare-participating medical professionals on a fee-for-service basis, under the Medicare Advantage program, private insurers directly pay for and manage policyholders’ Medicare benefits. [read post]
27 Apr 2012, 3:15 pm
By Ilyse Schuman The Centers for Medicare & Medicaid Services (CMS) has issued new guidance (pdf) on the medical loss ratio (MLR) requirement under the Affordable Care Act. [read post]
19 Jan 2021, 8:43 pm
This legislation also permitted CMS to contract with eligible contractors to perform program integrity activities. [read post]
10 Nov 2008, 2:47 pm
The contract became effective on October 1st. [read post]
12 Apr 2018, 8:48 am
At the present time, CMS has contracted with eGlobalTech (eGT) to analyze data and prepare “Comparative Billing Reports” (CBRs) of various services and claims billed to the Medicare program. eGT works directly with another CMS contractor, Palmetto GBA (Palmetto), to conduct the statistical work that is necessary to complete the CBR process. [read post]
18 Sep 2019, 2:08 pm
Big Changes to CMS Form 855 are on the Horizon (September 18, 2019): On September 10, 2019, the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published a Final Rule in the Federal Register entitled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process. [read post]
18 Sep 2019, 2:08 pm
(September 18, 2019): On September 10, 2019, the Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), published a Final Rule in the Federal Register entitled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process. [read post]
20 Nov 2017, 10:36 am
On November 16, CMS issued a proposed rule to update the Medicare Advantage and Prescription Drug Benefit Program for contract year 2019. [read post]
