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16 Apr 2018, 1:28 pm
Medical Loss Ratio (MLR) One of the often touted reforms of the ACA is requirement for insurers to spend a certain amount of premium revenue on medical claims and quality improvement activities or provide a rebate to enrollees. [read post]
7 Mar 2023, 7:56 am
[6] See Texas Medical Association, et al. v. [read post]
5 Oct 2006, 12:11 pm
The lessons involving the recent theft of laptop computers at the Veterans Administration have apparently been ignored by the Centers for Medicare and Medicaid Services (CMS). [read post]
8 Sep 2016, 2:39 pm
CMS will accept comments on the proposed rule until October 6, 2016. [read post]
19 Jul 2012, 1:51 pm
For 2013, CMS proposes to determine OPPS relative weights using the geometric mean costs of services within an Ambulatory Payment Classification, rather than median costs, which CMS expects would have a limited payment impact on most providers. [read post]
26 May 2010, 10:40 am
On May 21, 2010, CMS issued a new transmittal clarifying the interpretive guidelines for the hospital conditions of participation for anesthesia services. [read post]
29 Nov 2012, 11:31 am
On November 21, 2012, CMS announced that theFY 2012 Medicare fee-for-service program improper payment rate is 8.5% -- which represents $29.6 billion in improper payments. [read post]
29 Jul 2013, 2:28 pm
CMS is proposing to package into the comprehensive APCs all “adjunctive services” provided during the delivery of the comprehensive service, including: diagnostic procedures, laboratory tests and other diagnostic tests, and treatments that assist in the delivery of the primary procedure; visits and evaluations performed in association with the procedure; uncoded services and supplies used during the service; outpatient department… [read post]
19 Jul 2012, 1:27 pm
The second letter describes flexibility in the Medicaid statute that supports delivery system and payment reforms in fee-for-service systems. [read post]
3 Nov 2015, 11:40 am
The newest additions to the work plan are: • Medical device credits for replaced medical devices • Medicare payments during Medicare Severity Diagnosis Related Groups (MS-DRG) payment window • Content Management System (CMS) validation of hospital-submitted quality reporting data • Skilled nursing facility prospective payment system requirements • Orthotic braces-reasonableness of Medicare payments compared to amounts paid by other payers •… [read post]
14 Mar 2012, 12:18 pm
By giving beneficiaries clearer information regarding Medicare services billed on their behalf, CMS also expects the new MSN to help beneficiaries spot potential fraud. [read post]
25 Feb 2015, 2:00 pm
The Centers for Medicare & Medicaid Services (CMS) has finalized its Affordable Care Act (ACA) Marketplace health plan payment parameters and essential benefit standards for 2016. [read post]
20 Nov 2014, 1:11 am
On November 6, 2014, CMS published a final rule that makes significant and highly technical changes to Medicare payment policies for durable medical equipment (DME), prosthetics, orthotics, and supplies (DMEPOS). [read post]
9 May 2014, 10:00 am
According to CMS, all newly enrolling home health agencies (HHAs) and durable medical equipment (DME) suppliers are high risk. [read post]
9 May 2014, 10:00 am
According to CMS, all newly enrolling home health agencies (HHAs) and durable medical equipment (DME) suppliers are high risk. [read post]
9 May 2014, 10:00 am
According to CMS, all newly enrolling home health agencies (HHAs) and durable medical equipment (DME) suppliers are high risk. [read post]
11 Nov 2013, 1:16 pm
Questions on the two midnight provision for admission and medical review may be sent to CMS before the ODF begins via email to IPPSAdmissions@cms.hhs.gov. [read post]
24 Sep 2007, 11:00 pm
As part of the long-awaited final Stark Phase III regulations, the Centers for Medicare and Medicaid Services ("CMS") has once again focused on recruiting arrangements between hospitals and physicians. [read post]
1 Oct 2008, 9:49 am
[JURIST] The US Centers for Medicare and Medicaid Services (CMS) [official website] on Wednesday implemented regulations [text, PDF] denying hospitals payment for treating conditions caused by some common medical errors [HHS backgrounder]. [read post]
24 Sep 2007, 11:00 pm
As part of the long-awaited final Stark Phase III regulations, the Centers for Medicare and Medicaid Services ("CMS") has once again focused on recruiting arrangements between hospitals and physicians. [read post]
