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28 Mar 2018, 5:58 am by The Health Law Partners
Under the MSSP, an ACO’s quality and financial performance is assessed annually by the Center for Medicare and Medicaid Services (“CMS”) based on its assigned beneficiaries to determine whether the ACO has met the quality performance standards and reduced growth in expenditures compared to a historical financial benchmark. [read post]
23 Mar 2023, 1:02 pm by Ezra Rosser
In the final year of the Trump administration, just before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) sought to push the outer bounds of this question by announcing the Healthy Adult Opportunity (HAO) initiative. [read post]
In response to the recent Centers for Medicare & Medicaid Services (“CMS”) final rule prohibiting long-term care facilities from entering into pre-dispute arbitration agreements with its residents (the “Arbitration Rule”), several plaintiffs (including the American Health Care Association and other long-term care facility (“LTC”) providers) collectively filed a complaint on October 17, 2016 against CMS and the U.S. [read post]
19 Mar 2014, 2:08 pm
Under the Stark Law, hospitals are not allowed to bill Medicare for services if the doctors involved have a financial interest that is not proper. [read post]
29 May 2010, 8:52 pm by Jon L. Gelman
The Centers for Medicare and Medicaid Services (CMS) have filed a reply brief in US v Strickler, et al, now pending in the US District Court in Alabama, alleging that the government’s recovery action was valid and filed within the six years Statute of Limitations. [read post]
11 Jul 2013, 11:41 am
The only problem was that his method of collecting most of his company's revenues from Medicare and Florida Medicaid programs was performed illegally. [read post]
16 Jan 2014, 12:35 pm
On December 27, 2013, the Centers for Medicare & Medicaid Services ("CMS") issued revisions to Chapter 15 of the Medicare Program Integrity Manual. [read post]
17 Apr 2023, 12:15 pm by Joseph Allen
The program kicks in by imposing “maximum fair prices” for drugs as determined by the Centers for Medicare & Medicaid Services (CMS). [read post]
17 Apr 2023, 12:15 pm by Joseph Allen
The program kicks in by imposing “maximum fair prices” for drugs as determined by the Centers for Medicare & Medicaid Services (CMS). [read post]
On February 28, 2023, six of the seven Medicare Administrative Contractors (MACs), who administer Medicare reimbursement on behalf of the Centers for Medicare and Medicaid Services (CMS), came together for a multijurisdictional contractor advisory committee (CAC) meeting. [read post]
18 Jan 2017, 7:06 am by Daniel Anders
In its recently released Request for Proposal for the Workers Compensation Review Contractor (WCRC), the Centers for Medicare and Medicaid Services (CMS) includes an option allowing CMS to expand the responsibilities of the WCRC to review of Liability Medicare Set-Asides (LMSAs) and No-Fault Medicare Set-Asides (NFMSAs) effective July 1, 2018. [read post]
27 Apr 2009, 7:35 am
The Centers for Medicare and Medicaid Services ("CMS") recently published a final rule addressing termination of non-random prepayment complex medical review, which became effective January 1, 2009. [read post]
17 May 2011, 7:08 am by Deirdre Wheatley-Liss
 The states will then have to cut back on services, which is disproportionately effect the elderly as they are the biggest users of Medicaid services. [read post]
14 Apr 2017, 12:07 pm by Debra A. McCurdy
The Centers for Medicare & Medicaid Services has published a final rule intended to help improve the risk pool and stabilize the Affordable Care Act (ACA) Insurance Exchanges for 2018 – even as CMS contends that consumers “have faced double-digit premium increases, fewer plans to choose from, and a market that continues to be threatened by insurance issuer exits. [read post]
31 Dec 2010, 3:51 pm
Centers for Medicare and Medicaid Services' five-star system at their facilities. [read post]
5 Aug 2022, 12:59 pm by Law Offices of Thomas L. Gallivan, PLLC
The US Centers for Medicare and Medicaid Services has shelved a plan not to publish hospital safety ratings. [read post]
11 Apr 2023, 11:05 am by Ashley Morgan
Under traditional Medicare, health care providers are paid on a fee-for-service basis. [read post]
30 Apr 2002, 11:00 pm
In recent years, hospitals and their representatives have requested that the Centers for Medicare & Medicaid Services (CMS) (formerly HCFA) provide guidance on EMTALA’s applicability to certain situations which hospitals often face. [read post]