Search for: "CMS Medical Service"
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2 Apr 2020, 5:46 am
Is CMS suspending most Medicare Fee-For-Service (FFS) medical review during the Public Health emergency (PHE) period for the COVID-19 pandemic? [read post]
15 Mar 2013, 9:27 am
In many cases, hospitals have argued that the inpatient services were medically necessary. [read post]
8 Sep 2023, 5:00 am
The Centers for Medicare & Medicaid Services (CMS) recently announced that it intends to increase scrutiny on hospice providers as a result of increased reports and CMS findings suggesting potential hospice services fraud. [read post]
19 Jun 2012, 10:00 am
., Board Certified by The Florida Bar in Health Law Medicare providers are now able to submit medical documents to the Centers for Medicare & Medicaid Services (CMS) review contractors electronically for almost all of them. [read post]
CMS Announces Temporary Fee Schedule Increase for Certain Medical Equipment Furnished in Rural Areas
11 May 2018, 1:09 pm
Today the Centers for Medicare & Medicaid Services (CMS) published an interim final rule with comment period that will provide a temporary Medicare rate hike for certain durable medical equipment (DME) and enteral nutrition furnished in rural and non-contiguous areas of the country (Alaska, Hawaii, and U.S. territories) that are not included in competitive bidding. [read post]
17 Apr 2014, 12:15 pm
CMS has designated all newly enrolling home health agencies (HHA) and durable medical equipment (DME) suppliers as high risk. [read post]
17 Apr 2014, 12:15 pm
CMS has designated all newly enrolling home health agencies (HHA) and durable medical equipment (DME) suppliers as high risk. [read post]
15 Nov 2016, 1:02 pm
Under this program, CMS will direct Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), and the Supplemental Medical Review Contractor to make claims submitted by certain Advanced APMs providers a “low priority for medical record reviews. [read post]
18 Jun 2009, 9:24 am
Before the RACs begin conducting medical necessity reviews, they must receive approval of the areas planned for review by CMS's "issue review team. [read post]
1 May 2019, 1:09 pm
Currently the NTAP payment is set at the lesser of: (1) 50% of the costs of the new medical service or technology; or (2) 50% of the amount by which the costs of the case exceed the standard diagnosis related group (DRG) payment. [read post]
13 Jan 2014, 8:44 am
The Centers for Medicare and Medicaid Services (CMS) launched the initiative Partnership to Improve Dementia Care in Nursing Homes to lower the use of antipsychotic medication in nursing home facilities. [read post]
14 May 2009, 1:03 pm
The FAQ inquires what claim dates CMS uses to determine RAC medical record request limits for a fiscal year. [read post]
12 Mar 2013, 12:25 pm
§ 410.69, including CRNAs and AAs • Added "nonphysician" as clarification to the term anesthetist • Removed the applicable CRNA conversion factor from the calculation of the anesthesia services fee schedule for services on or after January 1, 1996 (i.e. after that date, the applicable CRNA conversion factor is no longer used in determining the fee schedule) • Added "reasonable and necessary" to the medical or surgical services performed by… [read post]
19 Jun 2012, 10:00 am
., Board Certified by The Florida Bar in Health Law Medicare providers are now able to submit medical documents to the Centers for Medicare & Medicaid Services (CMS) review contractors electronically for almost all of them. [read post]
31 Dec 2015, 1:11 pm
Centers for Medicare and Medicaid Services (CMS) issued a Final Rule earlier this week, which created prior authorization rules applicable to particular durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). [read post]
6 May 2017, 4:25 am
§ 1395y(b)(2)(B)(ii), does not as a matter of law equate to any medical items, devices, supplies, or services that appear under in a single line-item charge on a payment summary form issued by CMS. [read post]
2 Nov 2012, 2:22 pm
During the last few years, CMS' Recovery Audit Contractors (RACs) have determined that millions of dollars paid to hospitals for inpatient treatment should be refunded to CMS because although the patient needed the medical services provided, the services should have been provided on an outpatient basis. [read post]
16 Aug 2013, 2:00 pm
In an effort to curb elder abuse and protect the personal rights of long-term care residents, the Center for Medical Services (CMS) has issued a “reminder” to State Survey Agency Directors delineating the rights of LTC residents to receive visitors.... [read post]
23 Feb 2024, 5:00 am
In the Medicare Advantage (MA) program, overseen by the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage Organizations (MAOs) – typically private insurers – receive monthly payments from CMS. [read post]
21 Feb 2012, 8:08 am
In response to concerns raised by the American Physical Therapy Association (APTA) and other associations, the Centers for Medicare and Medicaid Services (CMS) has revised interpretative guidelines (Transmittal 72) to eliminate the requirement that rehabilitation services furnished in outpatient hospital settings be ordered by a practitioner with medical staff privileges. [read post]
