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17 Jan 2023, 11:04 am
The Centers for Medicare and Medicaid Services (“CMS”) has issued a proposed rule which would amend the existing regulations for reporting and returning identified overpayments (the “Proposed Rule”). [read post]
5 Nov 2010, 5:53 pm
A recent study in the journal Health Economics reported that nursing homes stand to gain profits if they increase their quality-of-care rating on the Nursing Home Compare report card from the Centers for Medicare & Medicaid Services. [read post]
17 Jun 2013, 3:06 pm
The CBP has been in effect for one year in nine areas, and, according to the Centers for Medicare & Medicaid Services ("CMS"), has already resulted in $202 million in savings. [read post]
14 Aug 2023, 7:13 am
[2] Centers for Medicare & Medicaid Services, Spotlight: Physician-Owned Hospital Expansion Exception Requests – Changes Effective October 1, 2023, available at https://www.cms.gov/medicare/fraud-and-abuse/physicianselfreferral/spotlight (last accessed August 2, 2023) [read post]
20 Jun 2013, 12:41 pm
The Centers for Medicare and Medicaid Services (CMS) contracts with sponsors that provide drug coverage to beneficiaries enrolled in Medicare Part D. [read post]
20 Mar 2009, 7:20 am
The Centers for Medicare and Medicaid Services’ (CMS) found during an audit of the discharge status codes of 150 sampled claims that 92 claims were improperly coded as discharges to home rather than transfers to post-acute care facilities. [read post]
28 Feb 2009, 6:54 pm
Governor Sebelius will inherit a department of 65,000 employees responsible for public health, food safety, scientific research, and the administration of the Medicare and Medicaid programs, which serve 90 million Americans. [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]
24 Feb 2012, 8:23 am
§1315) (1115 waiver), which was approved by the Centers for Medicare and Medicaid Services (CMS) on December 12, 2011. [read post]
20 Jun 2024, 8:57 am
On June 5, Bluestone Physician Services of Florida LLC, Bluestone Physician Services, P.A., and Bluestone National LLC agreed to pay $14.9 million to settle allegations of submitting false claims for certain Evaluation and Management (E&M) codes inconsistent with Medicare, Medicaid and TRICARE requirements. [read post]
9 Apr 2014, 7:06 am
The Centers for Medicare & Medicaid Services (CMS) has released its 2015 rate announcement and final call letter for Medicare Advantage (MA) and Part D prescription drug plans. [read post]
4 Nov 2022, 10:51 am
Anderson under the Tennessee Medicaid False Claims Act for the false claims he submitted to TennCare. [read post]
16 Jun 2020, 9:05 pm
Under the 2022 Medicaid option to establish health homes, states would be required to submit a plan to the Centers for Medicare and Medicaid Services (CMS) detailing how the state would work with health homes to ensure “prompt and timely access” to out-of-state care for children with medically complex conditions. [read post]
10 May 2007, 5:00 am
CMS has taken aggressive action to curb infusion therapy fraud and other organized fraud actions," said Leslie Norwalk, acting administrator of the Centers for Medicare and Medicaid Services. [read post]
26 Jan 2015, 6:30 am
CMS Review Provides Certainty By obtaining approval from the Centers for Medicare and Medicaid Services (CMS) prior to final settlement, all parties receive certainty from future government action or non-recognition of a settlement. [read post]
14 Jun 2012, 6:42 am
Centers for Medicare and Medicaid Services (CMS) said it’s launching the “Partnership to Improve Dementia Care. [read post]
6 May 2020, 9:37 am
The Centers for Medicare & Medicaid Services (“CMS”) recently issued recommendations to re-open certain healthcare facilities that have not been heavily impacted by COVID-19 to provide essential non-COVID-19-related care to patients without COVID-19 symptoms. [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]
12 May 2017, 12:15 pm
The Centers for Medicare & Medicaid Services (CMS) has waived some of these coverage restrictions in eight innovative demonstration projects and payment and delivery models. [read post]
30 Jul 2012, 7:49 am
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. [read post]
