Search for: "CMS MEDICARE CLAIMS OFFICE"
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28 May 2024, 12:08 pm
The agreement includes an annual review of the hospital’s Medicare claims by an Independent Review Organization to ensure compliance with Medicare rules. [read post]
14 May 2024, 5:00 am
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently announced that it intends to increase scrutiny of fee-for-service peripheral vascular procedures billed to the Medicare program. [read post]
25 Apr 2024, 9:30 pm
The Centers for Medicare and Medicaid Services (CMS) announced a final rule that creates minimum nurse staffing requirements for long-term care (LTC) facilities that receive Medicare and Medicaid funding. [read post]
10 Apr 2024, 3:45 pm
This bibliography comprises scholarly books, book chapters, and journal articles published or accepted for publication by full-time, emeritus, and retired faculty of the Sandra Day O’Connor College of Law between January 1, 2024 and March 31, 2024. [read post]
12 Mar 2024, 9:01 pm
Grimm, and Principal Deputy Administrator & Chief Operating Officer, Centers for Medicare & Medicaid Services (CMS) Jonathan Blum. [read post]
26 Feb 2024, 12:17 pm
And this spending shows little sign of slowing down: by 2031, the Center for Medicare and Medicaid Services (CMS) projects that Medicaid and the closely- related Children’s Health Insurance Program will cost over $1.2 trillion annually. [read post]
9 Feb 2024, 12:32 pm
False Claims Act Judgments: CMS could revoke or deny enrollment if a provider or supplier had a civil judgment imposed against them within the previous 10 years. [read post]
25 Jan 2024, 5:31 am
Although all Medicare-covered drugs and biologics have been FDA approved, not all FDA approved drugs and biologics will qualify for coverage and payment by Medicare and / or other payors. [read post]
16 Jan 2024, 11:33 am
But the rule I set out to defend—where ill-gotten evidence is excluded irrespective of the underlying crime or the nature of the officer’s misconduct—is dead, and it has been for a while. [read post]
15 Jan 2024, 6:00 am
But similar to the PHI administrative simplification rules, the HHS also delegated transaction rule enforcement to the Centers for Medicare and Medicaid Services (CMS). [read post]
5 Jan 2024, 11:20 am
Specifically, the government alleged that from 2014 to 2020, Moffitt billed Medicare and other federal healthcare programs for services not covered by CMS rules governing reimbursement for care provided in connection with clinical research trials. [read post]
22 Dec 2023, 9:33 am
Keegan, the regional attorney for the EEOC’s Atlanta District Office. [read post]
20 Dec 2023, 5:00 am
Second, the final rule expands CMS’s authority to revoke and deny enrollment if a provider, supplier, or any owner, managing employee or organization, officer, or director has had a civil judgment under the False Claims Act (FCA) imposed against them within the previous 10 years. [read post]
29 Nov 2023, 5:04 pm
This measure, together with new pharmacy contracting requirements and related enforcement provisions also included in the bill, would represent an important—albeit limited—modification to pharmacy network contracting rules under Part D, which have been limited by the statutory “non-interference clause” barring the Centers for Medicare and Medicaid Services (CMS) from interfering in contract negotiations between pharmacies and plans or their PBMs. [read post]
28 Nov 2023, 8:10 pm
Personal Injury Paralegal Boot Camp As a personal injury paralegal, you have an important role in the pre-litigation phase of your claim files. [read post]
20 Nov 2023, 10:19 am
The specific types of claims to be audited by the SMRC are selected by CMS. [read post]
19 Nov 2023, 11:35 am
NGHP includes workers’ compensation claims. [read post]
13 Nov 2023, 5:40 pm
., Medicare, Medicaid, Tricare). [read post]
5 Nov 2023, 3:10 pm
The CMS waiver programs required DADS to collect and report to CMS applicant and enrollee community and institutional service choice, Level of Care, Plan of Care, waiver provider choice and other waiver program performance data for CLASS and DBMD as part of a required evidentiary report on all §1915(c) waiver programs. [read post]
10 Oct 2023, 10:51 am
Government Accountability Office (GAO) has estimated that $46.8 billion was improperly paid in connection with Medicare Fee for Service (FFS), Medicare Advantage (Part C) and Medicare Prescription Drug (Part D) claims. [read post]
