Search for: "Center for Medicare/Medicaid Services"
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11 Dec 2023, 2:00 am
False Claims Act Violations: If proven, submitting false or fraudulent claims to government healthcare programs like Medicare or Medicaid could invoke the False Claims Act. [read post]
7 Dec 2023, 8:32 am
It is good practice to have the Centers for Medicare & Medicaid Services (“CMS”) review and approve the MSA prior to the parties’ finalizing settlement. [read post]
30 Nov 2023, 9:05 pm
The Centers for Medicare and Medicaid issued a final rule updating payment systems and reporting requirements for several Medicare programs, including the Medicare Hospital Outpatient Prospective Payment System. [read post]
30 Nov 2023, 8:22 am
Over half received “below average” or “much below average” ratings from the Centers for Medicare and Medicaid Services. [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… [read post]
28 Nov 2023, 10:00 am
This price comparison tool allows plan participants to “shop” and compare cost sharing regarding 500 “shoppable” services identified by the Centers for Medicare & Medicaid Services (CMS). [read post]
27 Nov 2023, 11:59 am
The Centers for Medicare and Medicaid Services (CMS) pays MA Plans a fixed (also known as capitated) amount for each enrolled beneficiary. [read post]
22 Nov 2023, 3:16 pm
That has led them to assisted living centers run by for-profit companies and pri [read post]
21 Nov 2023, 2:55 pm
The Centers for Medicare & Medicaid Services (CMS) classifies migraines as a disabling headache disorder “characterized by recurrent unilateral pulsatile headaches” and has assigned an ICD-10 code for billing and reimbursement purposes. [read post]
19 Nov 2023, 11:35 am
The Centers for Medicare and Medicaid Services [CMS] has published a final rule specifying how and when CMS must calculate and impose civil money penalties [CMPs] when non-group health plan [NGHP] responsible reporting entities [RRE] fail to meet their Medicare secondary payer [MSP] reporting obligations. [read post]
17 Nov 2023, 9:05 pm
For example, the Centers for Medicare and Medicaid Services eliminated certain restrictions on telehealth, including giving reimbursements for telehealth visits for rural and urban patients and allowing telephone-only visits, explains Copeland. [read post]
17 Nov 2023, 9:11 am
On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). [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]
16 Nov 2023, 8:47 am
The Centers for Medicare and Medicaid Services (CMS) is an agency within the U.S. [read post]
15 Nov 2023, 12:01 pm
The Center for Medicare and Medicaid has issued new rules requiring the disclosure of ownership of nursing homes and skilled nursing facilIties, including ownership by private equity firms. [read post]
15 Nov 2023, 9:00 am
On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining the 2024 Medicare payment rates and policy updates for hospital outpatient and Ambulatory Surgical Center (ASC) services. [read post]
15 Nov 2023, 8:32 am
DOJ alleged that the MAO received more than $53 million in overpayments from the Centers for Medicare & Medicaid Services (“CMS”) due to false diagnoses submitted on reimbursement claims for beneficiaries enrolled in the MAO’s plans. [read post]
15 Nov 2023, 7:56 am
” Healthcare is among the biggest expenses with Medicaid costs for “emergency services for undocumented aliens” exceeding $12.4 billion in the last two years, according to figures provided to committee members by the Centers for Medicare and Medicaid Services. [read post]
14 Nov 2023, 2:00 pm
Educate your healthcare clients on prohibitions regarding false statements for services provided to Medicare or Medicaid patients, as well as false statements made to qualify a facility for participation in a federal healthcare program. [read post]
13 Nov 2023, 5:40 pm
It creates crimes that are considered to protect the patient’s best interests by outlawing even the offer to exchange any kind of remuneration (even if it never happens) to get referrals for services or to get items that are eligible for monetary reimbursement under federal healthcare programs (e.g., Medicare, Medicaid, Tricare). [read post]
