Search for: "CMS CONTRACT MANAGEMENT SERVICES"
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23 Jan 2017, 4:57 am
As we previously reported, CMS considers pass-through payments to be amounts that states require to be added to the contracted payment rates between managed care organization and hospitals, physicians, or nursing facilities that are not for a specific service provided to a specific enrollee under the contract (and subject to certain other specifications). [read post]
22 Nov 2016, 6:59 am
CMS considers pass-through payments to be amounts that states require to be added to the contracted payment rates between managed care organization and hospitals, physicians, or nursing facilities that are not for a specific service provided to a specific enrollee under the contract (and subject to certain other specifications). [read post]
7 Nov 2016, 5:12 am
The report notes that examiners “also observed a [compliance management system (CMS)] weakness at one or more collectors that had not maintained any records showing the relationship between the amount of the collection fee and the cost of collection. [read post]
28 Oct 2016, 9:20 am
Earlier this year, the Centers for Medicare and Medicaid Services (CMS) issued a new rule that nursing homes that include binding arbitration clauses in their contracts will not be eligible for federal funding. [read post]
27 Oct 2016, 8:48 am
Based on these investigations, OCR concluded that while OHSU initially adopted HIPAA Policies, the reported breaches were the result of a series of widespread and ongoing breaches of HIPAA resulted including the following: From January 5, 2011, until July 3, 2013, OHSU disclosed the ePHI of 3,044 individuals in violation of Privacy Rules §§160.103 and 164.502(a) when workforce members disclosed the ePHI to a third party internet-based service provider without obtaining a business… [read post]
9 Oct 2016, 9:46 am
They also recommended that structured settlement broker/consultants expand their Medicare services. [read post]
9 Oct 2016, 9:46 am
They also recommended that structured settlement broker/consultants expand their Medicare services. [read post]
19 Jul 2016, 7:47 am
CMS also urges states to consider negotiating supplemental rebates with manufacturers for some or all of their Medicaid managed care drug claims, although CMS reminds states to determine the impact of such a decision on their contracts with managed care organizations. [read post]
5 Jul 2016, 10:21 am
Conclusion In sum, HHAs that provide home health services and physicians contracting with such HHAs and/or certifying the need for home health services should be wary of increased anti-fraud enforcement. [read post]
22 Jun 2016, 10:59 am
As mandated by the statute, CMS defines “private payor’’ as a health insurance issuer or a group health plan, a Medicare Advantage plan, or a Medicaid managed care organization. [read post]
3 Jun 2016, 1:13 pm
Why would blocking require a fee for service? [read post]
3 Feb 2016, 10:03 am
As also required under the FAR, OIG will calculate the total value of FAR contracts that CMS has not closed out and will seek to identify barriers to CMS managing and closing out FAR contracts. [read post]
2 Feb 2016, 1:15 pm
It is emerging that, at least under the OECD's framework Guidelines for Multinational Enterprises, financial institutions assume at least some minimal level of responsibility for the human rights detrimental conduct of clients (Should Financial Institutions Have Obligations to Manage the Human Rights Impacts of their Clients? [read post]
13 Jan 2016, 5:05 pm
Along those lines, the efficacy of using independent auditors, audit committees and management certifications to deter and minimize such insider misconduct became widely understood and embraced. [read post]
3 Nov 2015, 11:40 am
The newest additions to the work plan are: • Medical device credits for replaced medical devices • Medicare payments during Medicare Severity Diagnosis Related Groups (MS-DRG) payment window • Content Management System (CMS) validation of hospital-submitted quality reporting data • Skilled nursing facility prospective payment system requirements • Orthotic braces-reasonableness of Medicare payments compared to amounts paid by other payers •… [read post]
25 Oct 2015, 11:12 am
Scribe responsible for leading the American Bar Association (ABA) Joint Committee on Employee Benefits (JCEB) annual agency meeting with the Department of Health & Human Services Office of Civil Rights,Scribe responsible for leading the American Bar Association (ABA) Joint Committee on Employee Benefits (JCEB) annual agency meeting with the Department of Health & Human Services Cynthia Marcotte Stamer’s practice has focused on advising and representing government… [read post]
19 Oct 2015, 8:46 pm
Some of the more notable recruitment rule changes are that the Final Rule: Brings consistency to job order clearance by having job orders for all range occupations remain active until 50 percent of the work contract period has elapsed. [read post]
16 Oct 2015, 11:28 am
The Centers for Medicare and Medicaid Services (CMS) have the power to stop nursing homes from receiving federal funding should they include arbitration clauses in their contracts. [read post]
12 Oct 2015, 8:18 am
The solicitation also specified that CMS would evaluate the extent to which each offeror’s staffing plan “ensures that appropriately qualified staff are available to meet the requirements of this contract on an ongoing basis. [read post]
28 Sep 2015, 2:10 pm
Oil and gas service giant Halliburton, has agreed to pay $18,293,557 to 1,016 employees nationwide to settle charges by the U.S. [read post]
