Search for: "Center for Medicare and Medicaid Services"
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13 Jun 2011, 6:30 am
The OIG's success resulted from a collaborative effort with the Department of Justice, the Centers for Medicare & Medicaid Services, State Medicaid Fraud Control Units, other OIGs offices, State agencies and local law enforcement. [read post]
17 Dec 2016, 7:00 am
The current Federal Court decisional activity involving NJ operating pharmaceutical distributors is reviewed.The new Centers for Medicare and Medicaid Centers (CMS) Secondary Payer Act Secondary Payer Act (MSP) offset procedures and adopted regulations, implementing The SMART Act are presented in this supplement. [read post]
8 Sep 2014, 8:28 am
In an effort to reduce the amount of cases currently pending appeal, specifically the backlog at the Administrative Law Judge (ALJ) level of appeal, the Centers for Medicare & Medicaid Services (CMS) announced an offer to hospital appellants to settle their patient status claim denials currently pending appeal. [read post]
13 Apr 2008, 12:12 pm
Starting Oct. 1, the federal Centers for Medicare and Medicaid Services will stop reimbursing hospitals for the treatment of eight major preventable errors, including objects left in the body after surgery and certain kinds of post-surgical infections. [read post]
13 Jun 2017, 3:17 pm
" Given that the ACA's subject matter includes the provision of health services, health insurance, Medicare and Medicaid processes, and virtually every other aspect of healthcare and its insurance coverage, it would seem virtually impossible for a hospital employee to complain about something that was NOT related to the ACA's subject matter.For healthcare industry employers, this is a very easy standard to meet. [read post]
28 Oct 2014, 9:30 pm
The Centers for Medicare and Medicaid Services (CMS) recently proposed a rule that would significantly revise the criteria under which home health agencies (HHAs) qualify for federal funds. [read post]
20 Apr 2022, 6:03 pm
According to DOJ’s press release: Springbok Health Inc., a medical clinic with locations in Colorado Springs and Pueblo West, Colorado, and Mark Jankelow, Springbok’s owner and Chief Executive Officer, have agreed to pay at least $125,000, and up to as much as $335,494, to resolve allegations they violated the False Claims Act by billing Medicare and Medicaid for high-complexity and prolonged medical evaluation and management services when such … [read post]
12 Sep 2020, 11:46 am
While most health care and providers obtained a temporary reprieve from, Medicare, Medicaid and private payor administrative audits[1], many state and federal law enforcement agencies (such as the Federal Bureau of Investigation (FBI), the Department of Health and Human Services, Office of Inspector General (OIG), state Medicaid Fraud Control Units (MFCUs) have continued to investigate allegations of wrongdoing against sober home and recovery residence owners,… [read post]
3 Nov 2012, 7:32 pm
Centers for Medicare and Medicaid Services estimated that 14.5 million people will enroll in Medicare Advantage plans in 2013, based on insurance industry expectations. [read post]
31 Jul 2023, 1:05 pm
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 diagnoses of each plan beneficiary. [read post]
4 Jan 2012, 6:18 am
Recently, the Centers for Medicare and Medicaid Services (“Medicare”) released guidance (the “Alert”) relevant to conditional payment reimbursement under the Medicare Secondary Payer (“MSP”) Act (42 U.S.C. [read post]
4 Jan 2012, 6:18 am
Recently, the Centers for Medicare and Medicaid Services (“Medicare”) released guidance (the “Alert”) relevant to conditional payment reimbursement under the Medicare Secondary Payer (“MSP”) Act (42 U.S.C. [read post]
25 Sep 2014, 6:36 pm
Last month we wrote about the Centers for Medicare and Medicaid Services (CMS) quietly deciding to withhold some information about hospitals that make medical errors, but the feds apparently saw the error in that, and corrected their poor judgment. [read post]
25 Sep 2011, 11:54 am
A 2001 report by the federal Centers for Medicare and Medicaid Services also detailed deficiencies at the center, notably understaffing. [read post]
16 Jan 2021, 12:30 am
The proposed rule, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” updates and clarifies existing Departmental regulations to conform with statutory protections against disability discrimination, and establishes that HHS’ regulations:Protect patients, including infants born alive whose parents or guardians consent to treatment, from… [read post]
7 Mar 2022, 2:07 pm
The Centers for Medicare & Medicaid Services (CMS) notified Mallinckrodt in 2016 that it had been reporting an incorrect base AMP for Acthar and directed the company to correct its data reporting. [read post]
3 Oct 2011, 5:00 am
Apparently there is some movement inside the Centers for Medicare & Medicaid Services to include clinical trials within the MSP's onerous requirements and add still more expense to the development of new drugs, medical devices and vaccines. [read post]
11 Dec 2023, 2:00 am
False Claims Act Violations: If proven, submitting false or fraudulent claims to government healthcare programs like Medicare or Medicaid could invoke the False Claims Act. [read post]
20 Sep 2013, 2:46 am
Tony Salters, spokesman for the Centers for Medicare & Medicaid Services, said the agency has gotten other reports of callers “requesting personal information in order to gain access to a beneficiary’s Medicare number or other financial information. [read post]
31 Jan 2012, 7:15 am
On Friday, January 27, 2012, the Centers for Medicare & Medicaid Services (“CMS”) released its long-awaited proposed rule to implement the provisions of the Affordable Care Act (“ACA”) relating to pharmaceutical manufacturer payment of Medicaid rebates and limits on Medicaid reimbursement to pharmacies. [read post]
