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27 Nov 2012, 12:30 pm
The numbers are fairly enlightening: In 2010, 40 percent of Part A appeals and 53 percent of Part B appeals were granted, according to the Centers for Medicare & Medicaid Services, which administers Medicare (CMS). [read post]
26 Dec 2019, 12:29 pm
The Centers for Medicare & Medicaid Services (CMS) has posted the final Medicare clinical laboratory fee schedule (CLFS) rates for 2020. [read post]
10 Oct 2023, 11:53 am
In addition, the Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes. [read post]
25 May 2017, 7:23 am
The Centers for Medicare & Medicaid Services (CMS) is delaying until January 1, 2018 implementation of mandatory Medicare episode payment models (EPMs) for acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment procedures furnished in designated geographic areas. [read post]
1 Dec 2019, 5:00 pm
The “Improvement Standard” had become so ingrained in the system that part of the settlement included a rewrite of Medicare manuals by the Center for Medicare and Medicaid Services (CMS). [read post]
3 Oct 2011, 3:36 pm
News release: "The Centers for Medicare & Medicaid (CMS) has proposed revisions to the Medicare Advantage program and prescription drug... [read post]
10 Aug 2007, 4:32 pm
"Statehealthfacts.org has updated information on Medicare Advantage (MA) plans for 2007 based on analysis of the latest Centers for Medicare... [read post]
14 Feb 2014, 7:51 am
Tavenner, the administrator of the Centers for Medicare and Medicaid Services, said that “recalcitrant providers” would face civil fines and could be expelled from Medicare and other federal health programs. [read post]
14 Jan 2014, 6:30 am
A helpful statistic: “The Medicare Rights Center estimates that only about 2 percent of Medicare beneficiaries appeal denials of care, but 80 percent of those who appeal Part A denials and 92 percent who appeal Part B denials win more care. [read post]
13 Jan 2021, 12:34 pm
According to the Centers for Medicare & Medicaid Services (CMS), Medicare fraud continues to cost taxpayers over $40 billion each year. [read post]
30 Jun 2016, 6:01 am
Hospitals will be given a “target price” for total joint replacements for the patient’s entire care from the hospital stay to outpatient rehabilitation through 90 days after discharge, according to a new rule from the Center for Medicare Services. [read post]
3 Aug 2010, 8:44 pm
The Centers for Medicare & Medicaid Services (“CMS”) has recently released various notices and final rules updating 2011 Medicare payment rates for post-acute care providers, including long-term acute care hospitals (“LTACHs”), inpatient rehabilitation facilities (“IRFs”), skilled nursing facilities (“SNFs”), home health agencies (“HHAs”) and hospices. [read post]
6 Oct 2011, 1:51 pm
Larry Duran, a health care executive who defrauded Medicare of hundreds of millions of dollars while lobbying the government to ease Medicare restrictions on mental health centers, received a record-breaking fifty year prison sentence for his role in orchestrating the fraud. [read post]
12 Nov 2010, 6:00 am
Medicare Interactive is a good resource to keep at hand (associated with the New York and Washington D.C. based Medicare Rights Center). [read post]
12 Dec 2011, 6:23 pm
Auditors will begin the pilot program by focusing on inpatient hospital claims, especially those for short stays, and conduct the reviews before payment is authorized, said Deborah Taylor, director of the Office of Financial Management at the Centers for Medicare & Medicaid Services. [read post]
26 Aug 2008, 7:20 pm
According to the article, the Center for Medicare and Medicaid Services (CMS) has allowed alleged businesses who claim to be medical equipment suppliers to sign up for Medicare reimbursement eligibility when they were in fact sham businesses that never provided medical supplies to patients. [read post]
18 Aug 2011, 3:40 am
” The suit “alleges that such reliance by the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) results in payment rates that undervalue the services of primary care doctors. [read post]
27 Apr 2011, 3:55 am
" Two reports released this month by the Centers for Medicare and Medicaid Services are the "first to look strictly at how many times bedsores, surgical errors and falls and trauma, for example, occur among Medicare patients. [read post]
9 Feb 2024, 12:32 pm
The Centers for Medicare & Medicaid Services (CMS) has proposed a new rule that expands and enhances their authority to (A) deny enrollment, or (B) revoke Medicare billing privileges for healthcare providers and suppliers. [read post]
24 Feb 2023, 12:29 pm
Attorney’s Office for the Southern District of Texas announced on February 22 that Cornerstone Healthcare Group Holding Inc. and CHG Hospital Medical Center LLC. dba Cornerstone Hospital Medical Center will pay $21,637,512 to settle allegations that it improperly billed Medicare and violated the False Claims Act. [read post]