Search for: "Centers for Medicare and Medicaid Services (CMS)"
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17 May 2011, 12:47 pm
In early April, the Centers for Medicare/Medicaid Services CMS released two CMS Reporting Alerts regarding file processing changes: April 1, 2011 CMS Alert Update TIN Reference Response File and Address Validation April 5, 2011 CMS Alert Upgrade of Query Files and HEW Software TIN Reference Response File and Address Validation Alert Currently, CMS validates the TIN Reference Address Records and returns Compliance… [read post]
31 Mar 2011, 8:52 am
The Centers for Medicare & Medicaid Services (CMS) has issued proposed regulations that would establish accountable care organizations (ACOs) under the Medicare Shared Savings Program. [read post]
23 Apr 2018, 7:09 am
Centers for Medicare & Medicaid Services (CMS) is a division of the Department of Health and Human Services (HHS). [read post]
18 Jan 2023, 8:19 pm
By Faraz Siddiqui —Last week, the Centers for Medicare & Medicaid Services (CMS) released a memorandum on how it intends to implement the Medicare Drug Price Negotiation Program, passed under the Inflation Reduction Act (IRA) (see our blog post and slide deck on IRA). [read post]
13 May 2014, 6:30 am
Previously, the Centers for Medicare and Medicaid Services (CMS) had advised that, for purposes of Mandatory Insurer Reporting pursuant to the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) they would be discontinuing the use of ICD-9 codes and require the use of ICD-10 codes on all claims with a CMS date of injury of April 1, 2015 or later. [read post]
19 Aug 2015, 7:28 am
The Centers for Medicare and Medicaid Services ("CMS") and the Office of Inspector General ("OIG") have taken several steps recently to crack down on what it views as abusive PODs and POHs. [read post]
2 Jul 2012, 11:57 am
In coming to this conclusion the court relies on i) the broad language of the MSP Act as applied to private causes of action, ii) the policy and purpose behind the Federal Medicare Advantage (“MA”) program, and iii) the regulations promulgated by the Centers for Medicare and Medicaid Services (“CMS”). [read post]
2 Jul 2012, 11:57 am
In coming to this conclusion the court relies on i) the broad language of the MSP Act as applied to private causes of action, ii) the policy and purpose behind the Federal Medicare Advantage (“MA”) program, and iii) the regulations promulgated by the Centers for Medicare and Medicaid Services (“CMS”). [read post]
28 Dec 2010, 11:00 am
"We are pleased to be able to work in partnership with states as they continue to improve their Medicaid and CHIP programs and make them more accessible for families," said Cindy Mann, deputy administrator of the Centers for Medicare & Medicaid Services (CMS) and director of the Center for Medicaid, CHIP and Survey & Certification (CMCS). [read post]
3 Jul 2018, 1:12 pm
On January 11, 2018 the Centers for Medicare & Medicaid Services (CMS) released a letter to State Medicaid Directors announcing a commitment to support section 1115 demonstration projects that include work or community engagement requirements (HL Pulse summary here). [read post]
28 Oct 2016, 10:15 am
When the Centers for Medicare & Medicaid Services (CMS) released news of the final rule on September 28, San Diego nursing home residents already were protected against mandatory arbitration agreements under section 1599.81 of the California Health & Safety Code. [read post]
20 Nov 2017, 10:36 am
The proposed legislation reverses policy finalized on November 1 by the Centers for Medicare & Medicaid Services (CMS) in the hospital outpatient prospective payment system and the ambulatory surgical system final rule for calendar year 2018. [read post]
18 Jun 2011, 11:54 am
As you will recall, at the reconsideration level, Medicare claims are assessed by a Qualified Independent Contractor (QIC) selected by the Centers for Medicare and Medicaid Services (CMS) to hear the second level of administrative appeals. [read post]
15 Feb 2023, 4:25 pm
In addition to the risk of a “clawback,” or having to pay back the insurer for payments found to be in error, practitioners who fail audits face disciplinary actions from the private health insurance company, the Centers for Medicare & Medicaid Services (CMS), and the Illinois Department of Financial and Professional Regulation (IDFPR). [read post]
21 Apr 2010, 12:20 pm
Glossary of MSP Acronyms AWP Average Wholesale Price CMS Centers for Medicare and Medicaid Services (Formerly the Health Care Financing Administration (HCFA)) COB Coordination of Benefits Contractor DOI Date of Incident or Injury GHP Group Health Plans HICN Health Insurance Claim Number ICD-9 International Classification of Diseases, 9 th Edition MMA Medicare Modernization Act of 2003 MMSEA Medicare, Medicaid… [read post]
22 Jul 2009, 5:48 am
Industry stakeholders should anticipate, and be attentive to, future regulatory changes, as the Centers for Medicare and Medicaid Services (CMS) is expected to continue to focus on areas such as diagnostic imaging, which it believes are vulnerable to patient and program abuse, and which is among the fastest growing set of services paid for under Medicare Part B physician fee schedule. [read post]
28 Sep 2022, 12:50 pm
The whistleblower alleged that “PCG caused local school districts to submit claims to the Centers for Medicare and Medicaid Services (“CMS”) for evaluation services that PCG knew or should have known were not covered by Medicaid. [read post]
4 Mar 2009, 8:59 pm
Section 306 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) authorized the Centers for Medicare and Medicaid Services (CMS) to conduct a three-year demonstration program (Demonstration Project) using RACs to identify Medicare overpayments and underpayments and to recoup overpayments made to providers enrolled in the Medicare Fee-for-Service program. [read post]
17 Oct 2022, 5:00 am
The UPIC may also persuade the Centers for Medicare & Medicaid Services (CMS) to revoke the provider’s Medicare billing privileges because the UPIC’s probe audits have made it appear as though the provider has a pattern of submitting claims that do not meet Medicare requirements. [read post]
31 Mar 2009, 8:16 pm
LTACHs should speak with their dietary department or dietary service provider to determine what steps are being taken to ensure that patients are not served potentially contaminated products. * * * In a memorandum from the Survey and Certification Group, the Centers for Medicare and Medicaid Services (CMS) has… [read post]
