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12 Sep 2020, 11:46 am
In exchange for the referral of their residents for medical and clinical services (often in the form of drug screen testing), sober home and recovery home owners, operators (and affiliated Medical Directors) have received a “referral fee” or kickback from the servicing health care provider or supplier who then bills the resident’s insurance company for payment. [read post]
11 Sep 2020, 10:42 am
On September 2, 2020, the Centers for Medicare & Medicaid Services (CMS) finalized fiscal year (FY) 2021 policies in the Inpatient Prospective Payment System (IPPS) for acute care and long-term care hospitals. [read post]
8 Sep 2020, 1:50 pm
CMS has the authority to determine if a particular medical product or service is “reasonable and necessary” under § 1862(a)(1)(A) of the Social Security Act. [read post]
4 Sep 2020, 12:30 pm
On September 1, 2020, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that would establish a new Medicare coverage pathway, Medicare Coverage of Innovative Technology (“MCIT”), for medical devices that are designated by the Food and Drug Administration (“FDA”) as breakthrough devices. [read post]
4 Sep 2020, 9:01 am
On Wednesday, September 2, the Centers for Medicare & Medicaid Services (CMS) issued the FY 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) final rule. [read post]
4 Sep 2020, 6:23 am
On August 31, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released an announcement regarding their newest proposed rule, the Medicare Coverage of Innovative Technology (“MCIT”). [read post]
31 Aug 2020, 10:26 am
CMS is also requiring that the completion and results of each resident and staff COVID-19 test be appropriately documented in staff personnel records, resident medical records, or other individual files, as applicable. [read post]
27 Aug 2020, 9:05 pm
Department of Health and Human Services, reportedly stated that Trump Administration medical experts supported the idea, and there was no political pressure to change the guidelines. [read post]
Why is HHS blocking FDA from regulating some diagnostics, and how will this affect COVID-19 testing?
25 Aug 2020, 4:50 pm
And under the 1988 Clinical Laboratory Improvement Amendments (CLIA), most laboratories conducting LDTs need a certificate of compliance or accreditation every two years from the Centers for Medicare and Medicaid Services (CMS). [read post]
24 Aug 2020, 1:37 pm
On June 19, 2020, the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) and the Centers for Medicare & Medicaid Services (CMS) published a final rule scaling back nondiscrimination regulations first released in 2016 to implement Section 1557 of the Affordable Care Act (ACA). [read post]
24 Aug 2020, 9:33 am
Proposed Rule CMS’ Section 111 reporting is aimed at ensuring Medicare does not pay for medical care that should be covered by another entity. [read post]
17 Aug 2020, 2:21 pm
Only medical staff and employees get access, as well as some vendors and maintenance people. [read post]
17 Aug 2020, 10:51 am
Currently, there are two categories by which CMS evaluates new services for reimbursement by Medicare. [read post]
14 Aug 2020, 11:45 am
In addition, CMS notes that information included in the medical record should document that the services are reasonable and necessary. [read post]
11 Aug 2020, 5:16 am
As mentioned above, the first tranche was automatically distributed based on 2019 CMS payment data. [read post]
10 Aug 2020, 1:25 pm
The Centers for Medicare & Medicaid Services (CMS) has issued specific recommendations to nursing homes to help mitigate the spread of COVID-19. [read post]
5 Aug 2020, 10:55 am
Additionally, resident services furnished outside the scope of the approved graduate medical education programs to inpatients of a hospital in which they have their training program are considered separately billable physicians’ services. [read post]
4 Aug 2020, 8:11 am
A statement from the American Hospital Association called on CMS to “reverse this harmful policy to ensure hospitals can continue to provide the services people need the most. [read post]
4 Aug 2020, 8:06 am
On Friday, July 31, 2020, the Centers for Medicare & Medicaid Services (“CMS”) issued three fiscal year 2021 final rules, for Inpatient Psychiatric Facilities (“IPFs”), Skilled Nursing Facilities (“SNFs”), and hospices. [read post]
30 Jul 2020, 3:39 pm
Reimbursement from the Centers for Medicare and Medicare (CMS) for health technologies and services operates in just this fashion, encouraging the development of technologies by, essentially, subsidizing (and increasing) payment. [read post]
