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25 Mar 2020, 10:00 am
Because of these challenges, the Centers for Medicare and Medicaid Services (CMS) and other principal operating components of the United States Department of Health and Human Services (HHS) are issuing frequent guidance to our community. [read post]
23 Mar 2020, 1:28 pm
” [3] Prior to calendar year 2019, the Centers for Medicare and Medicaid Services (“CMS”) has considered an item or service to be “primarily health related” only if the primary purpose is to “prevent, cure, or diminish an illness or injury. [read post]
20 Mar 2020, 5:41 am
Consequently, along with its release of the 2020 Report, EBSA reminded plans, employers and other interested parties of the following previously published EBSA guidance about the MHPAEA mandates:FY 2019 Mental Health Parity and Addiction Equity Act (MHPAEA) Enforcement Fact Sheet, available at https://www.dol.gov/sites/dolgov/files/EBSA/laws-and-regulations/laws/mental-health-parity/mhpaea-enforcement-2019.pdfAppendix to FY 2019 MHPAEA Enforcement Fact Sheet, available at… [read post]
19 Mar 2020, 9:48 am
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,SECTION 1. [read post]
16 Mar 2020, 1:32 pm
Many State Medicaid programs already cover telehealth/telemedicine services provided to patients in their homes. [read post]
14 Mar 2020, 5:18 am
House Speaker Nancy Pelosi on Friday announced the deal with the Trump administration for an aid package from Congress that would provide free tests even for the uninsured, enhanced unemployment benefits by boosting food stamps, and federal funds for Medicaid. [read post]
12 Mar 2020, 8:05 am
But the F.D.A. could not offer the approval because the lab was not certified as a clinical laboratory under regulations established by the Centers for Medicare & Medicaid Services, a process that could take months. [read post]
11 Mar 2020, 2:07 pm
The agreement only technically binds Medicare, Medicaid and other government programs and private insurers participating in the meeting. [read post]
11 Mar 2020, 1:49 pm
The Centers for Medicare & Medicaid Services released guidance for Medicare Advantage Organizations, Part D Sponsors, and Medicare-Medicaid Plans; Guidance for use of Certain Industrial Respirators by Health Care Personnel; Guidance for Home Health Agencies; and Guidance for Dialysis Facilities. [read post]
9 Mar 2020, 10:26 am
(March 9, 2020): Last September, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process. [read post]
9 Mar 2020, 10:26 am
(March 6, 2020): Last September, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process. [read post]
5 Mar 2020, 8:19 am
On Wednesday March 4, 2020, the Centers for Medicare & Medicaid Services (CMS) released three guidance documents for health care providers relating to the coronavirus. [read post]
4 Mar 2020, 11:31 am
The Centers for Medicare and Medicaid Services (CMS) has engaged a number of third-party, UPIC contractors (such as Qlarent, AdvanceMed, the CoventBridge Group, and SafeGuard Services LLC) to perform program integrity audits of Medicaid dental claims around the country. [read post]
2 Mar 2020, 11:04 am
Along with assisting their health plan clients with these activities, brokers, consultants, TPAs, and other plan vendors also should evaluate the potential implications of the reforms in the 02/06/20 Proposed Rule as well as any relevant state law reforms on the advice and services they provide to their clients, as well as their potential responsibilities and exposures in light of the evolving state health and PBM transparency rules. [read post]
2 Mar 2020, 7:29 am
Among other things, the Proposed Rule, if adopted as proposed, would: Repeal regulations relating to the Early Retiree Reinsurance Program; Require health plans in state insurance markets to count drug rebates and price concessions retained by pharmacy benefit managers (PBMs) as administrative expenses. [read post]
25 Feb 2020, 4:17 pm
Stamer advises, represents and defends employers and other management clients and organizations; employer, union, multi-employer, association and other employee benefit plan plans, their sponsors, insurers and fiduciaries, plan administrators, administrative services, technology and other service providers, foreign and domestic governments, and others about employment and other services; health… [read post]
25 Feb 2020, 4:02 pm
Stamer advises, represents and defends employers and other management clients and organizations; employer, union, multi-employer, association and other employee benefit plan plans, their sponsors, insurers and fiduciaries, plan administrators, administrative services, technology and other service providers, foreign and domestic governments, and others about employment and other services; health… [read post]
25 Feb 2020, 3:00 pm
Separate from the bidding program, the Centers for Medicare & Medicaid Services (CMS) would be authorized to update DME rates based on retail prices through rulemaking, without using the inherent reasonableness process [$1.6 billion Medicare savings, $85 million in Medicaid savings]. [read post]
18 Feb 2020, 9:05 pm
The first rule, proposed by the Centers for Medicare and Medicaid Services (CMS) within HHS, would update the Organ Procurement Organization (OPO) conditions for coverage. [read post]
3 Feb 2020, 8:21 am
Stamer advises, represents and defends employers and other management clients and organizations; employer, union, multi-employer, association and other employee benefit plan plans, their sponsors, insurers and fiduciaries, plan administrators, administrative services, technology and other service providers, foreign and domestic governments, and others about employment and other services; health… [read post]
