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3 Nov 2023, 3:04 pm
Beginning with the fourth quarter of 2018 through the first quarter of 2020 (when Nostrum withdrew from the Medicaid Drug Rebate Program), Nostrum and Mulye did not pay these entire invoiced amounts, despite learning that the larger rebate invoices were tied to the price increase and inflation based rebate and being notified by Centers for Medicare & Medicaid Services (CMS) that it should pay the higher calculated amounts. [read post]
3 Nov 2023, 2:24 pm
The post Tribal self-governance at center of dispute over federal health care costs appeared first on SCOTUSblog. [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 10:00 pm
The US Centers for Medicare & Medicaid Services (CMS) has implemented a final rule, effective November 13, 2023, designed to enhance the oversight of hospice providers throughout the United States and increase regulatory scrutiny of poor-performing hospices through the Hospice Special Focus Program (SFP). [read post]
2 Nov 2023, 9:00 am
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) quietly added “Outreach Site/ Street” as an allowable place of service (POS) code for Medicare and Medicaid providers to use in claims submission for “street medicine” services provided. [read post]
2 Nov 2023, 7:00 am
Department of Health and Human Services Centers for Medicare & Medicaid Services and Office of the National Coordinator for Health Information Technology have proposed a rule that “would implement the provision of the 21st Century Cures Act specifying that a health care provider determined by the HHS Inspector General (OIG) to have committed information blocking shall be referred to the appropriate agency to be subject to appropriate disincentives …. [read post]
30 Oct 2023, 9:16 am
UCSF will receive funding for the program from the Centers for Medicare & Medicaid Services following the launch of the GUIDE model: Guiding an Improved Dementia Experience model. [read post]
30 Oct 2023, 5:00 am
In November 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule expanding their ability to revoke Medicare billing privileges of providers and suppliers. [read post]
29 Oct 2023, 10:08 pm
Medical gloves and insulin pumps are medical devices, for example, but wheelchairs and hospital beds are medical equipment.[4] Selling durable medical equipment (DME) or home medical equipment (HME) at the retail level is regulated and requires a license in many states.[5] DME is a specific medical term used by Medicare, Medicaid, and private insurance companies, and it covers wheelchairs, canes, crutches, hospital beds, and oxygen equipment, among other items. [read post]
27 Oct 2023, 3:34 pm
According to the government, “Putnam Community Medical Center provided diagnostic sleep testing services at its now-closed sleep center, which the United States and the State of Florida allege were not provided with adequate physician supervision as required under certain Medicare coverage determinations and regulations during the period from December 2013 through February 2019. [read post]
27 Oct 2023, 5:00 am
The regulation and administration of health care in the United States suggests a list of familiar institutional names — the Department of Health and Human Services, the Food and Drug Administration, Centers for Medicare & Medicaid Services, and the National Institutes of Health, to list a few. [read post]
26 Oct 2023, 2:02 pm
In addition to the National Elder Fraud Hotline, which the DOJ Report highlighted, whistleblowers can also bring False Claims Act cases to recover for Medicare and Medicaid frauds. [read post]
24 Oct 2023, 7:28 am
Despite increased fines imposed by the Centers for Medicare and Medicaid Services, this news is deeply concerning. [read post]
19 Oct 2023, 5:19 am
In an advisory opinion released on October 13, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) approved a plan by a muti-specialty practice to pay its employed physicians bonuses related to outpatient procedures performed by those physicians at ambulatory surgical centers (ASCs) operated by the physician practice entity requesting the opinion (the Requestor). [read post]
19 Oct 2023, 5:00 am
There is an urgent need for Congress to ensure this funding through the Center for Medicare Services. [read post]
19 Oct 2023, 5:00 am
” Violation of the AKS can result in severe penalties, including imprisonment of up to 10 years, a maximum fine of $100,000, and exclusions from Medicare and Medicaid reimbursement. [read post]
