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11 Nov 2011, 8:51 am
On November 1, 2011, CMS issued its 2012 Final Physician Fee Schedule ("Final Rule"), in part, to "address changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. [read post]
27 Jun 2013, 4:39 am
http://workers-compensation.blogspot.com/ Workers' Compensation: CMS Publishes WCMSA Operating Rules Dec 19, 2008 The Centers for Medicare and Medicaid Services (CMS) has now published a copy of its Operating Rules regarding the evaluation of set-aside proposals. [read post]
18 Feb 2014, 1:42 pm
The agreement also sets forth an educational campaign, in which CMS agreed to disseminate written materials to contractors, adjudicators, providers, and suppliers, and conduct national conference calls with providers and suppliers as well as Medicare contractors, Administrative Law Judges, medical reviewers, and agency staff, to communicate the policy clarifications and answer questions. [read post]
12 Jan 2010, 6:00 am
CMS (Centers of Medicare and Medicaid Services) has expressed an opinion that there is no specific time limit in its ability to seek recovery. [read post]
19 Jul 2016, 8:42 am
CMS also proposes to review 83 codes for 0-day global services that typically are reported with an evaluation and management (E/M) service with modifier 25 (which allows physicians to be paid for E/M services that would otherwise be denied as bundled). [read post]
12 Aug 2010, 3:47 pm
Documentation Requirements CMS proposes to require referring physicians to maintain a record of the patient’s signature on the disclosure notification, and to include such disclosure notification in the patient’s medical record. [read post]
28 May 2014, 12:00 am
In the past, CMS guidelines limited nursing homes to the use of brand-new single-use medical devices, such as endoscopes or blood pressure cuffs. [read post]
13 Oct 2015, 6:57 am
CMS cautions that the files may not be representative of a physician’s entire practice, since they include only Medicare fee-for-service information. [read post]
12 May 2017, 12:32 pm
CMS has announced revised Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule amounts for the period of July through December 2016, as required by the 21st Century Cures Act. [read post]
30 Sep 2016, 4:58 am
CMS will also implement a $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals. [read post]
10 Aug 2017, 4:04 am
In addition, CMS adopted its proposed subregulatory process for adopting changes to the ICD–10–CM medical code data set for the presumptive methodology lists. [read post]
14 Nov 2019, 10:15 am
As part of this rulemaking, CMS adopted significant changes to Medicare payment policies for durable medical equipment, prosthetics, orthotics, and supplies; these provisions are summarized in a separate post. [read post]
14 Oct 2013, 5:58 am
How will the Centers for Medicare & Medicaid Services (CMS) Notice of Proposed Rulemaking impact future medical costs in liability cases? [read post]
12 May 2017, 12:17 pm
In addition, CMS has not required the MACs to educate providers who refer patients for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) and home health services on supporting billing documentation and referral documentation, also contrary to federal internal control standards. [read post]
5 May 2016, 6:06 pm
Medical Homes. [read post]
28 Jun 2016, 1:11 pm
Earlier this month, the Senate approved S 2736, the Patient Access to Durable Medical Equipment Act of 2016, which would extend the current transitional blended rates through June 30, 2017; fully-adjusted rates would then be implemented for services furnished on or after July 1, 2017. [read post]
30 Nov 2011, 1:17 pm
When it was first enacted ten years ago, in 2001, CMS revised 42 CFR 410.32(d)(2) to require that "[t]he physician or [sic] (qualified nonphysician practitioner, as defined in paragraph (a)(3) of this section), who orders the service must maintain documentation of medical necessity in the beneficiary's medical record. [read post]
27 Jun 2012, 9:50 am
The issue that has most obviously not been addressed in the proposed future medical rules CMS offered in CMS-6047-ANPRM is an approach on handling compromised or limited recovery situations in personal injury and workers' compensation settlements. [read post]
24 Apr 2013, 1:48 pm
The Centers for Medicare & Medicaid Services (CMS) plans to make significant changes to the Recovery Auditor (RAC) program. [read post]
19 Aug 2019, 4:09 am
The Centers for Medicare & Medicaid Services (CMS) is planning a potentially-significant overhaul of Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its proposed annual DMEPOS policy update for calendar year (CY) 2020. [read post]
