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21 Dec 2010, 5:03 pm
Comments may be submitted to CMS at the following addresses: Electronically: http://www.regulations.gov Regular Mail: Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS–6028–P P.O. [read post]
13 Apr 2018, 11:48 am
On Monday, the Centers for Medicare and Medicaid Services (“CMS”) released (1) the Notice of Benefit and Payment Parameters for 2019 final rule (“Final Rule”), (2) the Final Annual Issuer Letter and (3) guidance on hardship exemptions and transitional policies. [read post]
31 Oct 2016, 9:40 am
According to the OIG, the documentation provided by the chiropractors for the questionable services did not support medical necessity. [read post]
18 Jan 2022, 3:36 am
CMS’ vaccine rule will cover 10.4 million health care workers at 76,000 medical facilities. [read post]
28 Oct 2014, 7:13 am
Most violations cited in enforcement actions related to inappropriate delays or denials of access to health services and medications for enrollees. [read post]
27 Nov 2017, 4:16 am
Provided a more gradual increase in the financial risk requirement for Medical Home Models. [read post]
14 Jan 2022, 2:25 pm
The majority concluded that CMS had the authority to issue the vaccine mandate rule under provisions in the Social Security Act that permit the agency to issue rules that “the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services. . .. [read post]
12 Jun 2012, 9:21 am
The court sets the matter for an evidentiary hearing and invites the USA to participate, although it always politely declines, stating that "the Centers for Medicare & Medicaid Services (CMS) does not review or verify counsel's determination of whether or not there is a recovery for future medical services or the determination of the amount to be held to protect the Medicare Trust Fund except under limited circumstances. [read post]
22 Nov 2019, 5:43 am
CMS identified 70 shoppable services (the same as identified in the proposed rule) and the hospital must select the rest. [read post]
21 Nov 2016, 2:46 pm
The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. [read post]
17 Jun 2016, 11:48 am
CMS then restated that the Demonstration’s goal is to assure that HHA services are medically necessary and reasonable; to determine this, the Medicare Administrative Contractors (MACs) reviewing the pre-claim review requests will evaluate the submitted documentation to assure that the beneficiary: 1) is confined to home at time of service; 2) is under a physician’s care; 3) receives care pursuant to a plan of care approved by the physician; 4)… [read post]
17 Jun 2016, 11:48 am
CMS then restated that the Demonstration’s goal is to assure that HHA services are medically necessary and reasonable; to determine this, the Medicare Administrative Contractors (MACs) reviewing the pre-claim review requests will evaluate the submitted documentation to assure that the beneficiary: 1) is confined to home at time of service; 2) is under a physician’s care; 3) receives care pursuant to a plan of care approved by the physician; 4)… [read post]
30 Oct 2013, 4:29 am
Cherokee Medical Services (S.D. [read post]
14 Jul 2009, 5:20 pm
Section 114(b) of the Medicare, Medicaid and SCHIP Extension Act of 2007 (”MMSEA”) required the Secretary of Health and Human Services to conduct a study on the feasibility of establishing national LTACH facility and patient criteria for purposes of determining medical necessity, appropriateness of admission, and continued stay at, and discharge from, LTACHs. [read post]
30 Sep 2013, 3:08 pm
Under contract by CMS, Safeguard Services LLC is the authorized producer of all CBRs. [read post]
17 Jul 2018, 8:39 am
CMS would also like to have a patient’s updated medical records follow the patient throughout the healthcare system. [read post]
19 Feb 2016, 1:42 pm
States are not required to cover medically unnecessary services and may set medical necessity criteria based on accepted medical practices and standards. [read post]
17 Sep 2013, 5:28 am
The guidance addresses standards for physician certification of hospital services, such as content, timing, authorization, and the medical record elements that meet the initial inpatient certification requirements. [read post]
24 Jun 2015, 11:13 am
The CMS Independence at Home Demonstration saved more than $25 million during its first performance year while delivering high-quality patient care, according to a June 18, 2015 CMS announcement. [read post]
26 Sep 2013, 4:13 pm
The Centers for Medicare and Medicaid Services (CMS) announced during its September 26, 2013 Open Door Forum that, for a period of 90 days, CMS will not permit Recovery Audit Contractors (RAC) to review inpatient admissions of one midnight or less that begin on or after October 1, 2013. [read post]
