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25 Nov 2020, 3:31 pm
CMS is also revising its Hospitals Without Walls program to only require ambulatory surgery centers (ASCs) enrolled as hospitals to provide 24-hour nursing services when there is one or more patients receiving services in the facility. [read post]
24 Nov 2020, 3:35 am
This issue touches us all from senior wellness professionals, medical staff, families, inter-resident connections, and those aging in place at home and alone. [read post]
13 Nov 2020, 1:22 pm
These circumstances could include, the beneficiary is deceased, the physician or beneficiary is not in the location where the service were provided, or when the necessary equipment for the service were not in the location where the services occurred. [read post]
10 Nov 2020, 8:25 am
All of them have lost contracts and been kicked out of states for poor services. [read post]
6 Nov 2020, 12:08 pm
On October 28, 2020, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period (IFR) in an effort to ensure that participants in CMS programs have no-cost access to any forthcoming Food and Drug Administration (FDA or Agency) authorized or approved COVID-19 vaccine. [read post]
4 Nov 2020, 5:10 am
CMS further clarifies that plans and issuers that are subject to Section 2713 of the Public Health Service Act must also cover, without cost sharing, the recommended preventative services that are integral to furnishing a COVID-19 specimen, regardless of whether these items and services are billed separately. [read post]
1 Nov 2020, 6:10 am
Instead, the agency noted the requirement of a positive COVID-19 test for the enhanced Medicare reimbursement — a requirement implemented in September — and said that if, upon review, the medical record lacks a positive test, that increased payment will be considered an overpayment and recouped by CMS.... [read post]
9 Oct 2020, 10:09 am
The Centers for Medicare & Medicaid Services (CMS) released the proposed Outpatient Prospective Payment System (OPPS) 2021 Rule on August 4th 2020. [read post]
7 Oct 2020, 6:56 am
Over time, CMS has adjusted language to tighten these requirements. [read post]
6 Oct 2020, 3:50 am
Typically, these people are nurses and doctors, as well as wellness check programs through CMS services. [read post]
2 Oct 2020, 12:36 pm
Department of Health and Human Services (HHS) agencies have dialed in on promoting and enforcing patients’ rights to access their health information. [read post]
1 Oct 2020, 3:51 pm
Health Insurance Illinois: On September 2, the Department of Insurance issued Bulletin 2020-17 to notify Illinois-licensed health insurance issuers that no state enforcement actions will be taken against issuers for availing themselves of CMS’ relaxed enforcement to provide financial relief to their small group and individual enrollees in the 2020 plan year, provided that it is done [read post]
30 Sep 2020, 5:00 am
“This is always an option CMS [Centers for Medicare and Medicaid Services] has in its arsenal but, in my experience, it’s rarely used. [read post]
28 Sep 2020, 8:58 am
Upon on-site review or other reliable evidence, CMS determines that the provider or supplier is either of the following: (i) No longer operational to furnish Medicare-covered items or services. [read post]
28 Sep 2020, 8:58 am
Upon on-site review or other reliable evidence, CMS determines that the provider or supplier is either of the following: (i) No longer operational to furnish Medicare-covered items or services. [read post]
28 Sep 2020, 5:20 am
These types of ambulance services are covered under Medicare Part B, provided that the services are deemed medically necessary. [read post]
25 Sep 2020, 11:41 am
Since 1994, CMS has participated in an interagency agreement with the DOJ which allows CMS pro [read post]
25 Sep 2020, 11:41 am
UPIC requests for medical records have often gone unanswered or unfulfilled. [read post]
15 Sep 2020, 2:41 pm
Last summer, a CMS study revealed nursing homes all over the country under-reported cases of neglect and abuse at their facilities. [read post]
14 Sep 2020, 6:42 am
On August 3, 2020, two issues were approved for review and posted on the Centers for Medicare & Medicaid Services (CMS) Recovery Audit program website: 0184 – Total Hip Arthroplasty: Medical Necessity and Documentation Requirements, and 0185 – Total Knee Arthroplasty: Medical Necessity and Documentation Requirements. [read post]
