Search for: "Medicare, Medicaid & Medical Suppliers"
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2 Apr 2014, 9:00 am
Targets ranged widely and included hospitals, medical providers, pharmacies, clinics, and medical equipment suppliers. [read post]
18 Mar 2014, 5:46 pm
CMS has launched a new Medicare Care Choices Model (Model) to allow Medicare beneficiaries with certain medical conditions to receive palliative care services from selected hospice providers without forgoing curative care services. [read post]
18 Feb 2014, 1:42 pm
The agreement also sets forth an educational campaign, in which CMS agreed to disseminate written materials to contractors, adjudicators, providers, and suppliers, and conduct national conference calls with providers and suppliers as well as Medicare contractors, Administrative Law Judges, medical reviewers, and agency staff, to communicate the policy clarifications and answer questions. [read post]
29 Jan 2014, 1:53 pm
These cardiac operations allegedly violated the False Claims Act because Medicare and Medicaid programs only reimburse health care providers for operations that are deemed medically necessary. [read post]
14 Jan 2014, 11:29 am
This off-label marketing leads to the submission of improper claims to the Medicare and Medicaid systems, which results in fraud. [read post]
8 Jan 2014, 8:44 am
CMS has issued regulations regarding emergency preparedness requirements for Medicare and Medicaid providers, Medicare Advantage/Part D policies, Medicare Secondary Payer rules, the ACA Basic Health Program, and 2014 Exchange enrollment deadlines. [read post]
6 Jan 2014, 10:11 am
The Centers for Medicare and Medicaid services (CMS) has proposed rules for the Medicare Secondary Payer (MSP) appeals process that will target the “applicable plan” as the primary responsible party for recovery. [read post]
23 Dec 2013, 10:39 am
Foret entered a guilty plea to charges he defrauded Medicare, Medicaid, and private insurance carriers out of almost $1 million. [read post]
10 Dec 2013, 1:01 pm
CMS has issued several major Medicare payment rules for 2014, including rules updating reimbursement for hospital outpatient departments, ambulatory surgical centers, physicians and other Part B providers, end-stage renal disease facilities, durable medical equipment suppliers, and home health agencies. [read post]
29 Nov 2013, 4:12 am
On November 27, 2013, the Centers for Medicare & Medicaid Services (CMS) finalized updates to payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2014. [read post]
25 Oct 2013, 3:00 pm
The article discusses the Center for Medicare and Medicaid Services's ("CMS's") recent addition of Supplemental Medical Review Contractor ("SMRC") audits to an already robust Medicare auditing environment. [read post]
4 Sep 2013, 12:08 pm
Health care fraud — fake billing to Medicare or Medicaid — can be very profitable for doctors, dentists, hospitals, care facilities, home health care providers, equipment suppliers: really, it’s a big temptation for anyone who is in a position to file a payment request to either federal government health care program. [read post]
27 Aug 2013, 7:23 am
As a result of the DOJ’s efforts, approximately $4.2 billion was deposited with the Treasury or Centers for Medicare & Medicaid Services (CMS) and to private persons during the fiscal year. [read post]
20 Aug 2013, 2:39 am
The Centers for Medicare and Medicaid Services will stop approving new or pending applications for ground ambulance suppliers in eight area counties including Harris – the nation’s leader in the number of private Emergency Medical Service providers. [read post]
23 Jul 2013, 11:59 am
The Centers for Medicare & Medicaid Services (CMS) is issuing demand letters seeking recoupment of reimbursement from medical providers and suppliers for Medicare beneficiaries that, according to data from the Social Security Administration (SSA), were allegedly "incarcerated" at the time services were provided. [read post]
17 Jun 2013, 3:06 pm
As of July 1, 2013, 799 suppliers will participate in Round 2 of the Competitive Bidding Program (CBP) for Medicare Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS), offering medical equipment and supplies to Medicare beneficiaries in the United States. [read post]
30 May 2013, 10:34 am
The Center for Medicare and Medicaid Innovation. [read post]
15 May 2013, 2:24 pm
On May 13, 2013, the American Orthotic and Prosthetic Association ("AOPA") filed suit in the federal district court for the District of Columbia against the Centers for Medicare and Medicaid ("CMS"), alleging that payment denials by CMS and its Recovery Audit Contractors ("RAC") are invalid. [read post]
26 Apr 2013, 7:18 am
On Thursday, April 25, 2013, the Centers for Medicare and Medicaid Services announced that it would delay implementing Phase 2 of its Ordering and Referring Physician Claims Editing program due to technical difficulties. [read post]
23 Apr 2013, 11:40 am
It also reveals that the federal government is becoming aggressive on referral and business arrangements outside of Medicare, Medicaid and government funded programs. [read post]
