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11 Feb 2010, 8:47 am
Recently, the Centers for Medicare & Medicaid Services (CMS) approved the following three national accreditation organization to provide the accreditation services for suppliers of the TC of advanced diagnostic imaging procedures: (1) the American College of Radiology; (2) the Intersocietal Accreditation Commission; and (3) the Joint Commission. [read post]
28 Jun 2023, 6:53 am
HHSC-OIG regularly conducts investigations and audits of Medicaid claims submitted by providers and suppliers and has the authority to prosecute individuals or entities involved in Medicaid fraud. [read post]
17 Dec 2021, 11:08 am
As we previously reported, the Centers for Medicare & Medicaid Services’ (CMS’s) interim final rule (the “Rule”) requiring full COVID-19 vaccination for staff and others at Medicare- and Medicaid-certified providers and suppliers (i.e., the “vaccine mandate”) was effectively stayed nationwide on November 30, 2021, by the U.S. [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]
10 Feb 2012, 11:09 am
In exchange for Medical Directorship positions, physicians reassigned their Medicare payments to various physical medicine companies. [read post]
24 Mar 2016, 10:44 am
CMS has released a complex and controversial plan – the Part B Drug Payment Model — to test new Medicare payment methods for certain Part B drugs to determine whether alternative payment designs will reduce Medicare expenditures while preserving or enhancing the quality of care provided to Medicare beneficiaries. [read post]
12 Nov 2006, 9:39 am
(The same may be said for various state Medicaid programs as well.) [read post]
23 Dec 2013, 10:39 am
Foret entered a guilty plea to charges he defrauded Medicare, Medicaid, and private insurance carriers out of almost $1 million. [read post]
16 Mar 2020, 1:32 pm
Medicare pays for many medical visits through this telehealth benefit. [read post]
20 Aug 2014, 8:13 am
For the latest news on health policy issues involving Medicare, Medicaid, HIPAA, OIG, FDA, and more, follow us at @ReedSmithHealth. [read post]
2 Dec 2021, 12:10 pm
As we previously reported, the Centers for Medicare and Medicaid Services’ (CMS) interim final rule (“the Rule”) requiring full COVID-19 vaccination for staff and others at Medicare- and Medicaid-certified providers and suppliers (i.e., the “vaccine mandate”) has been challenged in the U.S. [read post]
10 Oct 2023, 10:51 am
During FY 2022, the Centers for Medicare and Medicare Services (CMS) has estimated the Medicare Part B improper payment rate as 8.41%. while the improper payment rate for Durable Medical Equipment (DME) suppliers was estimated to be 25.24%.[2] Additionally, the Medicaid program improperly paid $80.6 billion in improper claims during FY 2022.[3] Notably, these estimates don’t even take into account the sizeable improper billings submitted to… [read post]
21 Jan 2022, 9:15 pm
Healthcare entities not regulated by Medicare and Medicaid, such as physician offices and assisted living facilities, are not covered by the vaccine mandate. [read post]
16 Apr 2013, 6:40 am
The OIG has issued reports on Medicare supplier surety bonds, private insurer reporting to the HealthCare.Gov plan finder portal, and the Medicaid Integrity Program. [read post]
29 Nov 2013, 4:12 am
On November 27, 2013, the Centers for Medicare & Medicaid Services (CMS) finalized updates to payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2014. [read post]
7 Nov 2017, 8:19 am
DOJ’s comments are notable, however, because the credit balances not only involved Medicare and Medicaid, but also TRICARE and the Department of Veterans Affairs, both of which are outside the scope of the 60-Day Overpayment Statute. [read post]
7 Mar 2011, 2:16 am
DME INDUSTRY VOICES COMPETITIVE BIDDING CONCERNS: A bipartisan briefing was held for House of Representatives staff on March 1, in order to hear the concerns of durable medical equipment (DME) suppliers with regard to the new Medicare DME competitive bidding program. [read post]
16 Jul 2018, 12:47 pm
UPICs are tasked with investigating instances of suspected fraud, waste, and abuse in the Medicare and Medicaid programs. [read post]
30 Jun 2010, 6:04 am
The Centers For Medicare and Medicaid Services (CMS) has published the CY2011 Proposed Medicare Physician Fee Schedule for public inspection. [read post]
17 Jul 2014, 6:36 am
On July 15, 2014, the Centers for Medicare & Medicaid Services (CMS) announced its plans to recompete the supplier contracts awarded in Round 2 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program and the National Mail-Order diabetic testing supplies competition, as it is required by statute to do at least every three years. [read post]
