Search for: "Medicare, Medicaid & Medical Suppliers"
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5 Nov 2021, 8:28 am
On November 4, 2021, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule requiring that Medicare-certified providers implement policies for vaccination of all health care workers against COVID-19. [read post]
5 Nov 2021, 5:54 am
Federal regulations provide 22 distinct reasons that the Centers for Medicare & Medicaid Services (CMS) may use to revoke a healthcare provider’s or supplier’s Medicare billing privileges. [read post]
4 Nov 2021, 2:59 pm
According to CMS, the only exempt Medicare and Medicaid providers are Religious Nonmedical Health Care Institutions (RNHCIs), Organ Procurement Organizations (OPOs), and Portable X-Ray Suppliers. [read post]
4 Nov 2021, 2:59 pm
According to CMS, the only exempt Medicare and Medicaid providers are Religious Nonmedical Health Care Institutions (RNHCIs), Organ Procurement Organizations (OPOs), and Portable X-Ray Suppliers. [read post]
29 Oct 2021, 9:03 pm
Billing Under the Number of a Credentialed Physician When the Actual Rendering Physician is Not Credentialed by Medicare or Medicaid While such a situation may be pursued as a mere overpayment, we have seen multiple instances where this type of conduct has been pursued under the False Claims Act. [read post]
29 Oct 2021, 9:03 pm
Billing Under the Number of a Credentialed Physician When the Actual Rendering Physician is Not Credentialed by Medicare or Medicaid While such a situation may be pursued as a mere overpayment, we have seen multiple instances where this type of conduct has been pursued under the False Claims Act. [read post]
11 Oct 2021, 7:59 pm
DFARS 252.204-7019 (interim) requires primes and subcontractors to submit self-assessment of NIST 800-171 controls through the Supplier Performance Risk System (SPRS). [read post]
1 Oct 2021, 9:19 am
Vendors and developers of mobile health apps and connected devices (“health apps”) that track or collect fitness or other health information that contain individually identifiable health information created or received by health care providers (“personal health records” or “PHR”) and their service providers (“collectively “PHR Vendors””) should verify their data security and breach notification policies and processes comply with applicable… [read post]
30 Sep 2021, 4:50 pm
As a part of this work, she has continuously and extensively worked with domestic and international health plans, their sponsors, fiduciaries, administrators, and insurers; managed care and insurance organizations; hospitals, health care systems, clinics, skilled nursing, long term care, rehabilitation and other health care providers and facilities; medical staff, accreditation, peer review and quality committees and organizations; billing, utilization management, management services… [read post]
21 May 2021, 12:48 pm
Financial arrangements with multiple related-party entities siphon off profits to sister therapy businesses, staffing agencies, suppliers, or other non-arm’s length enterprises. [read post]
3 Feb 2021, 10:20 am
The Centers for Medicare & Medicaid Services (CMS) initially introduced TPE reviews as a pilot program in only a few jurisdictions. [read post]
19 Jan 2021, 8:43 pm
Legislative Background: With the passage of the Medicare and Medicaid programs in 1965, the Centers for Medicare and Medicaid Services (CMS)[1] became authorized to perform a myriad of Medicare program functions, either directly or by contract. [read post]
19 Jan 2021, 8:43 pm
Legislative Background: With the passage of the Medicare and Medicaid programs in 1965, the Centers for Medicare and Medicaid Services (CMS)[1] became authorized to perform a myriad of Medicare program functions, either directly or by contract. [read post]
19 Jan 2021, 9:26 am
It involved Medicare, Medicaid, and TRICARE. [read post]
9 Jan 2021, 3:40 pm
We specialize in regulatory compliance reviews, UPIC audits of Medicare and Medicaid claims, and the defense of proposed State Medical Board disciplinary actions. [read post]
28 Dec 2020, 10:19 am
During this period, UPICs continued to conduct data mining and other targeting activities, it just held off sending out requests for records to health care providers and suppliers. [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]
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]
25 Sep 2020, 11:41 am
Medicare Revocation Actions for the Failure to Provide Medical Records Have Typically Sought a 10-Year Re-Enrollment Bar. [read post]
25 Sep 2020, 11:41 am
Medicare Revocation Actions for the Failure to Provide Medical Records Have Typically Sought a 10-Year Re-Enrollment Bar. [read post]
