Search for: "Medicare, Medicaid & Medical Suppliers"
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16 Jul 2009, 12:07 pm
According to the 2010 Proposed Physician Fee Schedule (PPFS), as of January 1, 2012, the Center for Medicare and Medicaid Services (CMS) proposes that Medicare payment be made only for the technical component (TC) of advanced diagnostic imaging services to suppliers who have met the accreditation requirements set forth by the Secretary. [read post]
31 Jul 2007, 7:45 am
RodrigueThe medical necessity of durable medical equipment (“DME”) billed to the Medicare Program may have no relevance to a court’s determination of whether a DME supplier submitted claims based on fraudulent Certificates of Medical Necessity (“CMN”). [read post]
28 Sep 2020, 8:58 am
”[1] Among its many changes, the Final Rule significantly expanded the reasons that may be asserted by the Centers for Medicare and Medicaid Services (CMS) when revoking a health care provider’s enrollment and Medicare billing privileges. [read post]
11 Jan 2016, 3:00 am
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule to require Medicare prior authorization (PA) for certain durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) items that the agency characterizes as “frequently subject to unnecessary utilization. [read post]
17 Nov 2023, 5:26 am
The Centers for Medicare & Medicaid Services (CMS) has published its final rule that requires nursing homes enrolled in Medicare and Medicaid to disclose additional ownership and management information to CMS and state Medicaid agencies. [read post]
4 Jul 2016, 8:31 am
CMS also requests comments on a series of issues related to timely access to DME benefits for individuals dually eligible for Medicare and Medicaid. [read post]
7 Jan 2010, 10:46 am
Medicare is not supposed to be free medical care. [read post]
15 Nov 2022, 7:36 pm
Because Medicare is a government program and the government relies on trustworthy practitioners to provide excellent medical care to potentially vulnerable patients, investigators with the Centers for Medicare and Medicaid Services (CMS) are motivated to find and investigate those who may be acting in ways that are not conducive to Medicare’s overall aims. [read post]
25 Feb 2016, 3:45 pm
On February 25, 2016, the Office of Medicare Hearings and Appeals (OMHA) hosted a Medicare Appellant Forum for Part A and B providers and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers with important updates on management of the appeals backlog within OMHA, the Centers for Medicare & Medicaid Services (CMS) and Departmental Appeals Board (DAB) launch of the Appellant Public Portal, and the Phase III rollout… [read post]
3 Feb 2022, 6:00 am
The Centers for Medicare & Medicaid Services (CMS) authorizes several types of contractors to conduct audits, such as Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), Unified Program Integrity Contractors (UPICs), and the Supplemental Medical Review Contractor (SRMC). [read post]
16 Nov 2017, 5:57 am
Delays AUC Requirement until 2020, Cuts Off-Campus Hospital Department Payments The Centers for Medicare & Medicaid Services (CMS) has published its final Medicare physician fee schedule (PFS) rule for CY 2018. [read post]
28 Feb 2011, 5:15 am
In a report issued last week, the Centers for Medicare and Medicaid Services (CMS) states that National Government Services, Inc. [read post]
3 Feb 2015, 1:47 am
Reduce Medicare indirect medical education add-on payments ($16.3 billion). [read post]
31 Aug 2012, 5:48 am
" Medicare and Medicaid pay out some $750 billion dollars each year (at least $65 billion dollars a year is lost to fraud) to more than a 1.5 million doctors, hospitals and medical suppliers. [read post]
26 Jun 2018, 7:28 am
As we reported last April, the Centers for Medicare and Medicaid Services (CMS) announced in its Final Call Letter for bids from plans that participate in the Medicare Advantage program (MA) for 2019. [read post]
27 Aug 2009, 2:10 pm
The Centers for Medicare and Medicaid Services (CMS) recently issued Transmittal 297, which provides that, as of September 8, 2009, only one durable medical equipment (DME) vendor shall be allowed to store and/or sell DME items at a physician’s or a physician group’s office, and sets forth specific requirements that must be met in connection with these arrangements. [read post]
8 Apr 2018, 7:19 pm
(Ref: 7/11/05 Memo Q13) Effect of WCMSA on Medicaid Eligibility Medicaid Social Security Income (SSI) is a need-based benefit. [read post]
10 May 2018, 9:54 am
CMS solicits public comments on the possible establishment of CMS patient health and safety requirements for hospitals and other Medicare-and Medicaid-participating providers and suppliers for interoperable EHR and systems for electronic health care information exchange, along with ways to address barriers that prevent patients from being able to access and control their medical records. [read post]
13 Mar 2019, 3:30 am
The Centers for Medicare & Medicaid Services (CMS) has announced its plans for Round 2021 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP), featuring new “lead item” bidding rules and new product categories. [read post]
23 Feb 2024, 5:00 am
In the Medicare Advantage (MA) program, overseen by the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Organizations (MAOs) – typically private insurers – receive monthly payments from CMS. [read post]
