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28 Jun 2012, 11:53 am by Debra A. McCurdy
Reed Smith also released a series of in-depth analyses of the law, including alerts focusing on the law’s fraud and abuse/program integrity provisions, along with issues specifically impacting drug, device and biotech manufacturers and medical equipment suppliers and manufacturers. [read post]
14 May 2012, 10:14 am by Matthew Huisman
She focuses her practice on regulatory issues, transactions and compliance efforts with a specific emphasis on Medicare and Medicaid payment systems. [read post]
14 May 2012, 8:13 am by Debra A. McCurdy
The first rule reforms requirements that hospitals and critical access hospitals (CAHs) must meet in order to participate in the Medicare and Medicaid programs. [read post]
14 May 2012, 5:05 am by Debra A. McCurdy
”  At the hearing, the GAO issued a report reiterating its recommendations to minimize improper Medicare payments (such as using prepayment controls to identify potentially-improper DME claims and enhanced payment safeguards for physicians who use advanced imaging services) and improve oversight of Medicaid payments. [read post]
8 May 2012, 2:18 pm by Debra A. McCurdy
Among other things, the rule: Requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all Medicare and Medicaid enrollment applications and claims. [read post]
2 May 2012, 9:47 pm
However, the insurance industry and the federal government as a provider of Medicare/Medicaid could not sustain the exponential expense of medical care, advancing technologies, healthcare demand and fraud. [read post]
1 May 2012, 6:49 am by Mark Alderman
According to a final rule issued by CMS on Tuesday (4/24), all providers and suppliers who qualify for a National Provider Identifier (NPI) will be required to include the NPI on any enrollment applications to Medicare and Medicaid. [read post]
30 Apr 2012, 1:06 pm
On April 27, 2012 the Centers for Medicare and Medicaid Services (CMS) published a final rule that states new provider and supplier requirements. [read post]
18 Apr 2012, 9:07 am by fraudfighters
It has become all too common in the healthcare industry for durable medical equipment suppliers to market and provide medical supplies to seniors that are unnecessary and unwanted. [read post]
5 Apr 2012, 12:03 pm by Christie Britt, MBA MSCC AIC
Section 521 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) included provisions aimed at improving the Medicare fee-for-service appeals process. [read post]
20 Mar 2012, 6:48 am
The Centers for Medicare and Medicaid Services (CMS) has published a final rule for standards regarding Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers. [read post]
16 Mar 2012, 8:06 am
The Acting Administrator of the Centers for Medicare & Medicaid Services (CMS), Marilyn Tavenner, announced the redesign of the statement that informs Medicare beneficiaries about their claims for Medicare services and benefits. [read post]
14 Mar 2012, 12:59 pm by Debra A. McCurdy
HHS has released final Affordable Care Act insurance exchange regulations, and CMS has issued a final rule revising Medicare DMEPOS supplier standards and a notice on advanced diagnostic imaging supplier accreditation. [read post]
13 Mar 2012, 6:33 pm by Cynthia Marcotte Stamer
Stamer available including: New Guidance On Fiduciary Duties In Handling ACA Group Health Plan Premium Rebates Highlight Advisability Of Tightening Funding Terms & Fund Handling Practices To Manage Fiduciary Risks Mental Health Parity Guidance On Mental Health & Substance Abuse Copays, Utilization Management Limits Released DFW Hospital Council Foundation Among 26 Organizations Selected To Lead Quality Effort Group Health Plans & Insurer To Get More Time To Meet… [read post]
14 Feb 2012, 11:13 am
On February 7, 2012, The Centers for Medicare and Medicaid Services (CMS) released a Request for Comments regarding two demonstration programs it intends to conduct. [read post]
14 Feb 2012, 5:30 am by Ben Vernia
The fraud prevention and enforcement report announced today coincides with the announcement of a proposed rule from the Centers for Medicare and Medicaid Services aimed at recollecting overpayments in the Medicare program. [read post]
10 Feb 2012, 11:09 am
In exchange for Medical Directorship positions, physicians reassigned their Medicare payments to various physical medicine companies. [read post]
9 Feb 2012, 8:35 am
The Centers for Medicare and Medicaid Services (CMS) has now posted Self-Referral Disclosure Protocol (SDRP) settlements on the CMS website. [read post]
27 Jan 2012, 10:19 am
All Medicare suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) must obtain and maintain a surety bond of at least $50,000 to participate in the Medicare program. [read post]