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19 Feb 2008, 1:33 am
After October 1, 2008, Medicare will no longer pay hospital bills which arise from: 1. [read post]
18 Jan 2021, 6:45 am
On January 15, 2021, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to help strengthen and streamline the Medicare Advantage and Part D prescription drug programs, with the goal to decrease enrollee cost sharing on expensive prescription drugs. [read post]
15 Oct 2019, 2:08 pm
For each code, the Centers for Medicare & Medicaid Services (CMS) announces whether it intends to use crosswalking or gapfilling to establish the payment rate, along with the agency’s rationale for its decision. [read post]
7 Dec 2015, 8:45 am
Two related dermatology and cosmetic medical entities, Rhode Island Dermatology and Cosmetic Center, LLC, and Rhode Island Dermatology OBS, LLC recently paid $152,043.25 to resolve civil allegations that they violated the federal False Claims Act by billing Medicare for some patient services and procedures performed at rates higher than were warranted.The investigation was conducted by the U.S. [read post]
21 Feb 2019, 4:22 am
The Centers for Medicare & Medicaid Services (CMS) plans to test a new voluntary emergency ambulance service innovation model that seeks promote “the most appropriate level of care at the right time and place. [read post]
16 Aug 2019, 4:46 pm
The Centers for Medicare & Medicaid Services (CMS) has published its final fiscal year (FY) 2020 Medicare hospice payment rule. [read post]
14 Aug 2014, 3:06 pm
How about Medicare? [read post]
7 Nov 2011, 6:04 am
CMS Announcements on Fixed Percentage Option for Settlements of $5,000 or less, $300 Threshold Limit for Reimbursement, and Identification of Contractor for Medicare Secondary Payer Recovery The Centers for Medicare and Medicaid Services (“CMS”) announced an option which will allow for payment of a simple fixed percentage on small dollar liability insurance or self-insurance settlements for physical trauma-based injuries. [read post]
7 Nov 2011, 6:04 am
CMS Announcements on Fixed Percentage Option for Settlements of $5,000 or less, $300 Threshold Limit for Reimbursement, and Identification of Contractor for Medicare Secondary Payer Recovery The Centers for Medicare and Medicaid Services (“CMS”) announced an option which will allow for payment of a simple fixed percentage on small dollar liability insurance or self-insurance settlements for physical trauma-based injuries. [read post]
10 Oct 2011, 2:56 am
Centers for Medicare and Medicaid Services. [read post]
16 Nov 2009, 10:59 am
More than 85,000 physicians and other eligible professionals who successfully reported quality-related data to Medicare under the 2008 Physician Quality Reporting Initiative (PQRI) received incentive payments totaling more than $92 million, up from the $36 million paid in 2007, according to a new Centers for Medicare & Medicaid Services (CMS) report. [read post]
16 Apr 2012, 10:00 am
Highmark had the contract with the Centers for Medicare & Medicaid Services (CMS) to be the Medicare Administrative Contractor (MAC), formerly known as a "Carrier" or "Fiscal Intermediary," for Jurisdiction 12, which includes Delaware, New Jersey, Pennsylvania, Maryland and Washington, D.C.... [read post]
11 Nov 2019, 1:50 pm
On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) published its CY 2020 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule. [read post]
22 Aug 2022, 5:00 am
The federal agency that oversees Medicare, the Centers for Medicare & Medicaid Services (CMS), performs few audits itself. [read post]
23 Jul 2024, 12:46 pm
In its recently released 2025 proposed Medicare Physician Fee Schedule (“MPFS”), the Centers for Medicare & Medicaid Services (“CMS”) proposed two important modifications to the Medicare 60-day overpayment refund rule—a new “identified overpayment” standard and codification of a 6-month timeframe to investigate and quantify an overpayment. [read post]
15 Jan 2016, 2:08 pm
The National Acadmies of Sciences, Engineering, and Medicine: “The Centers for Medicare & Medicaid Services (CMS) announced a ruling in July 2015 to pay doctors to counsel patients about end-of-life care or “advance care planning,” a term meant to reflect that people should make their end-of-life wishes known as early as when they get a driver’s license and should reevaluate their decisions at different stages of life. [read post]
9 Jan 2018, 11:24 am
The Centers for Medicare & Medicaid Services (CMS) released Part I of the 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C Risk Adjustment Model and the use of encounter data. [read post]
17 Sep 2018, 11:37 am
Today the Centers for Medicare & Medicaid Services (CMS), in order to promote Medicaid and Medicare program efficiency, transparency, and burden reduction, proposed new rules that revise the applicable conditions of participation (CoPs) for providers and conditions for coverage (CfCs). [read post]
29 Jul 2013, 2:26 pm
However, recently compliance plans have become even more important for sleep labs, sleep centers, hospital-based sleep service providers, and non-hospital-based sleep service providers seeking Medicare reimbursement. [read post]
22 Mar 2019, 10:00 am
With regard to other Medicare fee-for-service payment systems, MedPAC recommends: Eliminating the ambulatory surgical center (ASC) update for 2020 and requiring ASCs to submit cost data. [read post]
