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5 Mar 2020, 5:32 am
The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would extend and modify the Comprehensive Care for Joint Replacement (CJR) Model, under which CMS makes a “bundled” payment to participant hospitals for an “episode of care” for lower extremity joint replacement (LEJR) surgery, covering all services provided during the inpatient admission through 90 days post-discharge (with certain exceptions). [read post]
31 Aug 2003, 11:00 pm
On September 9, 2003, the Centers for Medicare & Medicaid Services (“CMS”) published final regulations that modify the obligations of a Medicare-participating hospital under the Emergency Medical Treatment and Active Labor Act (“EMTALA”). [read post]
31 Aug 2003, 11:00 pm
On September 9, 2003, the Centers for Medicare & Medicaid Services (“CMS”) published final regulations that modify the obligations of a Medicare-participating hospital under the Emergency Medical Treatment and Active Labor Act (“EMTALA”). [read post]
18 Dec 2013, 12:46 pm
On Thursday, December 19, 2013, from 1:00-2:00 pm Eastern Time, the Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to answer questions from hospitals, practitioners, and other interested parties about the new policies released on August 2, 2013 as part of the Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS)/Long-Term Care Hospital (LTCH) Final Rule (CMS-1599-F) and corresponding medical review… [read post]
28 Feb 2012, 8:15 am
CMS recently released the results of its Medicare Fee-for-Service Recovery Audit Program (RAC) for fiscal year 2012. [read post]
20 Dec 2011, 1:22 pm
On December 14, the Centers for Medicare and Medicaid Services (CMS) announced a proposed rule that would require drug and medical device manufacturers to report their payments to physicians to federal regulators. [read post]
6 May 2011, 2:23 pm
It also increases access to medical services by distant sites in more remote, rural areas. [read post]
31 Aug 2012, 11:02 am
On September 5, 2012, CMS is hosting a Special Open Door Forum (ODF) on Manual Medical Review of Therapy Claims. [read post]
2 Nov 2012, 9:22 am
During the last few years, CMS’ Recovery Audit Contractors (RACs) have determined that millions of dollars paid to hospitals for inpatient treatment should be refunded to CMS because although the patient needed the medical services provided, the services should have been provided on an outpatient basis. [read post]
17 Aug 2007, 6:46 am
Last month the West Virginia Bureau of Medical Services received from CMS a $4.1M notice of disallowance stating that the state failed to share a portion of the settlement with federal Medicare.Larry Messina's article in today's Herald Dispatch, "Feds threaten $4.1M in Medicaid funds over Oxy Settlement". [read post]
30 Nov 2012, 9:05 am
Posted by Lynn SessionsCo-authored by: Cory Fox The Department of Health and Human Services Office of Inspector General (“OIG”) recently published a report, CMS Response to Breaches and Medical Identity Theft (“Report”), which referenced 14 breaches of medical information by the Centers for Medicare and Medicaid Services (CMS), including Medicare numbers, affecting nearly 14,000 beneficiaries in the past two years. [read post]
25 Sep 2017, 3:04 pm
The Centers for Medicare & Medicaid Services (CMS) CMS has announced a “new direction” for the CMS Innovation Center that is intended to “promote patient-centered care and test market-driven reforms. [read post]
10 Dec 2013, 11:15 am
For 2014, CMS is calculating OPPS relative payment weights using distinct cost-to-charge ratios for cardiac catheterization, CT scan, and MRI, and implantable medical devices. [read post]
19 Nov 2014, 10:57 am
CMS defines repetitive ambulance service as medically necessary ambulance transportation that is furnished in 3 round trips or more times during a 10-day period, or at least once per week for at least 3 weeks. [read post]
5 Aug 2015, 3:48 pm
The Centers for Medicare and Medicaid Services (CMS) has announced that it intends to speed up its collections practices enforcing the Medicare Secondary Payer Act (MSP). [read post]
1 Aug 2006, 2:23 am
The period of ineligibility will begin with the later of the first day of a month during or the month after which assets have been transferred for less than fair market value, or the date on which the individual is eligible for medical assistance under the state plan and is receiving institutional level of care services that, were it not for the imposition of the penalty period, would be covered by Medicaid. [read post]
28 Jan 2015, 12:48 pm
On December 30, 2014, the Centers for Medicare & Medicaid Services (CMS) announced that they had awarded the Region 5 Recovery Audit Contract (RAC) to Connolly, LLC. [read post]
Second Chance with MSA Approval: New CMS Policy Allows for Review of a New MSA Post a Prior Approval
26 Jul 2017, 6:30 am
On July 10, 2017, the Centers for Medicare and Medicaid Services (CMS) quietly rolled out a new policy allowing for a re-review of a previously approved Medicare Set-Aside which is between one and four years post-submission and for which there is a certain dollar amount change in projected future medical care since that time. [read post]
21 Jun 2022, 12:56 pm
Additionally, hospitals must publish a consumer-friendly, searchable tool that displays in plain language the prices of 300 shoppable medical services that a consumer can schedule in advance. [read post]
30 Mar 2022, 9:02 pm
At the beginning of 2022, Medicare Part B beneficiaries began paying 14.5 percent more for their monthly premiums, which cover medical services such as doctors’ services and outpatient care. [read post]
