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16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
16 Jul 2020, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) recently announced that it intends to resume both prepayment and postpayment medical reviews conducted by the Medicare Administrative Contractors, Supplemental Medical Review Contractors, and Recovery Audit Contractors, including those under the Targeted Probe and Educate program, on August 3, 2020. [read post]
24 Mar 2020, 7:39 pm by Lisa Baird
Centers for Medicare and Medicaid Services (CMS) issued to health care providers urging limitations on elective surgeries and nonessential procedures. [read post]
  Specifically, CMS is increasing the NTAP payment to the lesser of:  (1) 65% (up from 50%) of the costs of the new medical service or technology; or (2) 65% (rather than 50%) of the amount by which the costs of the case exceed the standard DRG payment. [read post]
15 Aug 2019, 1:57 pm by Thomas W. Greeson and Debra A. McCurdy
CMS proposes to streamline documentation requirements by allowing the physician, PA, or advanced practice registered nurse who furnishes and bills for his or her professional services to review and verify — rather than fully re-document — information included in the medical record by physicians, residents, nurses, students or other members of the medical team. [read post]
17 Aug 2020, 10:51 am by Wachler & Associates, P.C.
Currently, there are two categories by which CMS evaluates new services for reimbursement by Medicare. [read post]
24 Sep 2021, 3:44 pm by luiza
CMS suspended three UnitedHealth Medicare Advantage (MA) plans and one Anthem MA plan this week for failing to meet federal Medical Loss Ratio requirements. [read post]
4 May 2012, 11:59 am
CMS will not require manufacturers of drugs, devices, biological, or medical supplies to begin collecting Sunshine Act data on their payments and gifts to physicians and teaching hospitals until January 2013. [read post]
6 Jun 2011, 8:28 am
On Friday, June 3, the American Medical Association (AMA) submitted its comments to Donald Berwick of the Centers for Medicare and Medicaid Services (CMS) regarding CMS' proposed rule for Accountable Care Organizations (ACOs). [read post]
16 Jun 2014, 12:58 pm
Often times, these services are down-coded because CMS determined that the level of E/M service billed is not supported by the accompanying medical records (e.g., the visit note did not support the level of medical decision making component required by the code that was billed). [read post]
21 Sep 2016, 8:34 am by Wachler & Associates, P.C.
”  Noridian purports that this policy will help it to fulfill its obligations to the Centers for Medicare and Medicaid Services (CMS) by assuring that all Medicare claims are for medically necessary and reasonable services. [read post]
21 Sep 2016, 8:34 am by Wachler & Associates, P.C.
”  Noridian purports that this policy will help it to fulfill its obligations to the Centers for Medicare and Medicaid Services (CMS) by assuring that all Medicare claims are for medically necessary and reasonable services. [read post]
28 Mar 2013, 7:59 am
., co-chairs of the firm's Medicare and RAC department authored an ABA Health eSource article titled "CMS Acquiesces to Hospital Pressure, Allows Part B Billing of Hospital Services Following Part A Denial of Inpatient Hospital Claims for Medical Necessity: Is It Enough?" [read post]
28 May 2014, 12:14 pm by Cynthia Marcotte Stamer
July 28, 2014 is the deadline for concerned persons to comment on the Centers for Medicare & Medicaid Services (CMS) proposed rule requiring prior authorization for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). [read post]
28 May 2014, 12:14 pm by Cynthia Marcotte Stamer
July 28, 2014 is the deadline for concerned persons to comment on the Centers for Medicare & Medicaid Services (CMS) proposed rule requiring prior authorization for certain durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). [read post]
28 Feb 2011, 5:15 am
In a report issued last week, the Centers for Medicare and Medicaid Services (CMS) states that National Government Services, Inc. [read post]