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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]
4 Aug 2020, 8:06 am
On Friday, July 31, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued three fiscal year 2021 final rules, for Inpatient Psychiatric Facilities (“IPFs”), Skilled Nursing Facilities (“SNFs”), and hospices. [read post]
28 Jul 2015, 7:14 pm
Medicare regulations are often complex, ambiguous (especially when applied), and bereft of any guidance by the Centers for Medicare and Medicaid Services (CMS) or the local Medicare administrative contractor. [read post]
28 Jul 2015, 7:14 pm
Medicare regulations are often complex, ambiguous (especially when applied), and bereft of any guidance by the Centers for Medicare and Medicaid Services (CMS) or the local Medicare administrative contractor. [read post]
19 Apr 2019, 9:43 am
The Centers for Medicare and Medicaid Services (“CMS”), which oversees the Medicare program, adjusts the payments to MA Plans based on demographic information and the health status of each plan beneficiary. [read post]
23 Nov 2011, 12:00 pm
In addition, HHS's Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers. [read post]
20 Feb 2023, 5:00 am
CMS, the Centers for Medicare and Medicaid Services, issued a downloadable guidance on this topic. [read post]
7 Dec 2011, 4:55 am
By Emily Mapp Brannon, Virginia Medical Malpractice Attorney In his latest post to our Virginia (VA) personal injury attorneys’ website, my colleague Jim Lewis reports the federal Centers for Medicaid & Medicare Services will open its Medicare billing database to employers and consumer health care advocates so those organizations can prepare doctor report cards. [read post]
13 Oct 2021, 9:47 am
Defendants then submitted these medically unnecessary and impermissibly self-referred claims to Medicare and Medicaid for reimbursement in violation of the FCA. [read post]
15 Oct 2021, 9:39 am
Keeping Track of Nursing Home Facilities with Track Records of Abuse and Neglect In an effort to protect elderly residents, the Centers for Medicare & Medicaid Services (CMS) established the Special Focus Facility (SFF) program that identifies nursing homes that have very poor records of caring for residents. [read post]
12 Nov 2021, 9:28 am
The Centers for Medicare and Medicaid Services (CMS) reports that more than 1 in 10 nursing home residents suffer abuse or neglect. [read post]
17 Sep 2014, 9:57 am
” In other words, Medicare and Medicaid paid claims for services that did not actually help patients living in these facilities. [read post]
3 Apr 2017, 5:00 am
However, the Plaintiff asserted that the Defendant subsequently breached the terms of the parties’ settlement agreement by deducting the full amount of the Medicare lien from the Plaintiff’s gross settlement and forwarding those funds directly to the Center for Medicare and Medicaid Services, thereby depriving the Plaintiff of her ability to negotiate the Medicare lien down. [read post]
12 Dec 2014, 10:33 am
On December 1, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would postpone penalties against accountable care organizations (ACOs) for three years. [read post]
16 Jan 2014, 12:41 pm
On January 14, 2014, the Centers for Medicare & Medicaid Services ("CMS") announced a new policy regarding requests made under the Freedom of Information Act ("FOIA") on amounts paid to individual physicians under the Medicare program. [read post]
27 Feb 2011, 9:47 am
Please note that the claims must be separately identifiable by Medicare number (HICN) and dates of service. [read post]
26 Sep 2022, 3:46 am
In 1977, Joseph Califano (the Secretary, HEW), on orders from President Jimmy Carter, created that Health Care Financing Administration (HCFA).[8] When HCFA was first created, its primary mission was to consolidate the management and administration of the Medicare and Medicaid programs under a single authority.[9] On June 14, 2001, HCFA was renamed the Centers for Medicare & Medicaid Services (CMS). [read post]
25 Jan 2009, 1:17 pm
Petitioners were denied Medicaid eligibility due the transfers. [read post]
24 Apr 2015, 2:05 pm
If you have information concerning Medicaid or Medicare fraud by a hospital, doctor or other healthcare provider, do not hesitate to take action. [read post]
2 Nov 2012, 4:04 pm
In an almost ironic turn of events, in a July 13, 2012 memorandum that our firm obtained from a MAC, the Centers for Medicare & Medicaid Services (CMS), while professing that it still believed that hospitals were not entitled to full Part B reimbursement in these situations, directed all MACs and other fiscal intermediary contractors to effectuate ALJ orders for full Part B reimbursement. [read post]
