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15 Sep 2011, 6:57 am
Senators asking the Office of Inspector General ("OIG") and the Centers for Medicare and Medicaid Services ("CMS") to issue guidance on physician owned distributorships ("PODs") (or, sometimes referred to as physician owned intermediaries ("POIs")). [read post]
25 Apr 2014, 11:49 am
During reviews of E/M services, CMS contractors often determine that the level of E/M service billed by the physician is not supported by the corresponding medical records, which results in the contractor down-coding the level of E/M service (e.g., 99214 is down-coded to 99213). [read post]
15 Mar 2013, 12:42 pm
On March 13, 2013, the Centers for Medicare & Medicaid Services ("CMS") released a Proposed Rule and Administrator's Ruling that provide for significant revisions to Medicare's Part B payment policy when a Part A hospital inpatient claim is denied as not medically necessary because the care was not provided in the appropriate setting. [read post]
11 Jan 2016, 3:00 am
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule to require Medicare prior authorization (PA) for certain durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS) items that the agency characterizes as “frequently subject to unnecessary utilization. [read post]
2 Dec 2021, 8:18 am
Department of Health and Human Services Xavier Becerra, CMS, Administrator for the CMS Chiquita Brooks-LaSure, Deputy Administrator of CMS Meena Seshamani, Deputy Administrator and Director of Center for Medicaid and CHIP Services Daniel Tsai, and the U.S. [read post]
5 Nov 2021, 8:28 am
CMS does confirm that “suppliers are not required to ensure the vaccination of individuals who infrequently provide ad hoc non-health care services . . . or services that are performed exclusively off-site, not at or adjacent to any site of patient care. [read post]
16 Nov 2017, 5:57 am
As a result of comments, CMS mitigated somewhat the additional reduction for these services. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
22 Feb 2023, 10:00 pm
In doing so, CMS rejected application of a fee-for-service adjuster (FFS Adjuster) to allow for permissible threshold errors emanating from third-party provider medical record documentation. [read post]
1 Dec 2021, 9:36 am
A Louisiana federal district court has issued a nationwide injunction barring the Centers for Medicare and Medicaid Services (CMS) from enforcing its COVID-19 vaccine mandate for healthcare workers. [read post]
10 May 2018, 9:54 am
CMS also seeks comments on a number of actions it could take to help patients understand their potential financial liability for hospital services and to compare charges for similar services across hospitals. [read post]
11 Jun 2020, 9:00 am
On Tuesday, June 9, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released a guide for patients who are considering their in-person care options following certain healthcare facilities re-opening for all medical services. [read post]
3 Aug 2018, 12:46 pm
Therefore, although CMS removed the requirement for an inpatient hospital admission order to be present in the medical record as a condition of payment, an inpatient hospital admission order is still relevant and necessary. [read post]
6 Nov 2018, 2:59 pm
CMS will make payment for items and services furnished in non-excepted off-campus provider-based departments using a PFS Relativity Adjuster of 40%. [read post]
19 Nov 2015, 10:20 am
CMS is particularly interested in the submission of suggested topic areas such as communication with providers, rehabilitation, functional status, pain management/control or non-pain symptom management, discharge planning, family training, rehabilitation services, medical and nursing care, interdisciplinary team goal setting, and care planning. [read post]
14 Nov 2019, 11:00 am
The Centers for Medicare & Medicaid Services (CMS) is seeking public input on surveys that are intended to “further strengthen the monitoring, outreach, and enforcement functions” of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program – even though the agency has asserted that the program “has maintained beneficiary access to quality products from accredited suppliers in all… [read post]
