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16 Sep 2014, 7:36 am
The Centers of Medicare and Medicaid Services (“CMS”) will review…Read more › [read post]
16 Sep 2014, 7:36 am
The Centers of Medicare and Medicaid Services (“CMS”) will review…Read more › [read post]
1 Jun 2010, 7:12 am
Last week the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule revising the conditions of participation (CoPs) for hospitals and critical access hospitals allowing for a new credentialing and privileging process for physicians and practitioners who provide telemedicine services. [read post]
6 Aug 2013, 9:57 am
ED visits and observation services; However the Final Rule deviates from CMS' proposal in that it will allow hospitals to rebill physical therapy, occupational therapy and speech therapy services; and • Administrative law judge jurisdiction remains limited to whether the Part A claim at issue was medically necessary. [read post]
15 May 2014, 12:52 am
CMS published a final rule on May 2, 2014 setting forth the methodology and payment rates for the new prospective payment system for FQHC services under Medicare Part B. [read post]
15 Nov 2011, 6:16 am
There must be a reasonable connection between the items or services and the medical care of the beneficiary. [read post]
13 Feb 2014, 12:14 pm
CMS also has clarified related provisions regarding physician orders for and certification of hospital inpatient services. [read post]
13 Feb 2014, 12:14 pm
CMS also has clarified related provisions regarding physician orders for and certification of hospital inpatient services. [read post]
14 Jun 2017, 5:06 pm
N724—Patient must use No-Fault Set-Aside funds to pay for the medical service or item. [read post]
1 Nov 2012, 3:31 pm
The American Hospital Association ("AHA") and four hospitals (collectively, the "Plaintiffs") have filed a lawsuit against the Department of Health and Human Services ("HHS"), alleging that the Centers for Medicare and Medicaid Services ("CMS", a sub-agency of HHS), through its Medicare RAC Program, has inappropriately refused to pay for Medicare Part B services that it acknowledges were reasonably and medically… [read post]
13 Sep 2011, 12:34 pm
Complex Reviews - CMS describes complex reviews as "occur[ring] when a Recovery Auditor makes a claim determination utilizing human review of the medical record. [read post]
1 Oct 2014, 4:12 pm
The open-data play by the Centers for Medicare and Medicaid Services was mandated under provisions of the 2010 health care overhaul. [read post]
21 Jun 2012, 7:19 am
Earlier this month, the federal Centers for Medicare & Medicaid Services (CMS) announced an initiative to reduce the use of antipsychotic drugs on nursing home patients with dementia by 15 percent by the end of the year. [read post]
27 Aug 2013, 5:39 am
NF: A review of the medical necessity determinations revealed errors. [read post]
6 May 2019, 2:55 pm
On May 3, the Centers for Medicare & Medicaid Services (CMS) published its long-awaited draft “Guidance for Hospital Co-location with Other Hospitals or Healthcare Facilities. [read post]
8 Feb 2015, 5:02 pm
Publicly Released: Feb 6, 2015: “The Centers for Medicare & Medicaid Services (CMS), within the Department of Health and Human Services (HHS), has undertaken a number of efforts to prepare for the October 1, 2015, transition to the 10th revision of the International Classification of Diseases (ICD-10) codes, which are used for documenting patient medical diagnoses and inpatient medical procedures. [read post]
23 Feb 2023, 5:00 am
Under the RADV program, CMS identifies improper risk adjustment payments made to Medicare Advantage Organizations (MAOs) in situations where medical diagnoses submitted for payment allegedly were not supported in the beneficiary’s medical record. [read post]
23 Mar 2020, 8:51 am
State laws continue to govern whether a provider is authorized to provide professional services in that state without holding an active license from that state’s medical board. [read post]
17 Jan 2011, 10:51 am
Well ask and CMS shall receive. [read post]
10 Jun 2015, 3:38 pm
In particular, the GAO expresses concern that the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC) process for reviewing Medicare physicians' services' work relative values relies on the input of physicians who may have potential conflicts of interest with respect to the outcomes of CMS's process. [read post]
