Search for: "In Interest of CM"
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4 Apr 2023, 12:58 pm
Before defining the scope of research and development costs that will be considered in establishing a “maximum fair price,” CMS arbitrarily caps the annual cost of manufacturer capital at 8.1 percent, with no method of accounting for future interest rate increases or inflation. [read post]
12 Nov 2010, 4:04 am
It is important to recognize that the 36 Month Rule only applies to CHOWs affecting a direct ownership interest, not an indirect ownership interest. [read post]
16 Jan 2014, 12:35 pm
On December 27, 2013, the Centers for Medicare & Medicaid Services ("CMS") issued revisions to Chapter 15 of the Medicare Program Integrity Manual. [read post]
22 Sep 2015, 6:30 am
Monitor CMS websites for updates related to conditional payment matters. [read post]
18 May 2011, 4:03 am
These questions involve a due process analysis, which consists of a three part balancing test: 1) the private interest affected; 2) the risk of erroneous deprivation and probable value of additional safeguards, and 3) the government or public interest in current procedures. [read post]
8 Aug 2013, 5:15 am
CMS is seeking input on the following specific issues: Whether physicians have a privacy interest in information concerning payments they receive from Medicare and, if so, how to properly weigh the balance between that privacy interest and the public interest in disclosure of Medicare payment information, including physician-identifiable reimbursement data; What specific policies CMS should consider with respect to disclosure of individual physician… [read post]
24 May 2024, 7:27 am
May 23, 2024 • Volume 5 Issue 246 INTERESTING NEW LAW A federal mandate that sets minimum staffing requirements for nursing homes was recently finalized by the Centers for Medicare and Medicaid Services (CMS). [read post]
13 Sep 2013, 7:44 am
These programs may be of interest to providers as well as payers who are interested in what providers are doing to use eHealth tools. [read post]
20 Jun 2011, 3:00 am
Sebelius which restrict the application of interest while an appeal is pending. [read post]
8 Jan 2018, 1:04 pm
Where a treating physician believes tapering is possible and in the best interests of the claimant, CMS will consider all evidence in making a WCMSA determination, including medical evidence of current actual tapering. [read post]
14 Jun 2012, 4:03 pm
The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for submitting a Notice of Intent to Apply to June 29, 2012 for Accountable Care Organizations (ACO) interested in participating in the Shared Savings Program beginning January 1, 2013. [read post]
28 Jun 2017, 6:30 am
Conclusions The WCMSA review process is unavoidable when the settling parties require the assurance of CMS’s stamp of approval Claims management teams and other interested stakeholders can save their programs time and money by fully understanding and properly planning and coordinating both the MSA submission and re-review of a counter-higher if necessary. [read post]
28 Jun 2017, 6:30 am
Conclusions The WCMSA review process is unavoidable when the settling parties require the assurance of CMS’s stamp of approval Claims management teams and other interested stakeholders can save their programs time and money by fully understanding and properly planning and coordinating both the MSA submission and re-review of a counter-higher if necessary. [read post]
23 Jan 2014, 9:18 am
After a balancing of the interests, the judge determined that the public interest superseded physician privacy. [read post]
19 May 2008, 7:39 pm
The federales are now pushing the latest CMS demo promoting physician hospital collaboration. [read post]
8 Oct 2019, 2:00 pm
OR Category #2: Preclusion List – Conduct / Behavior Based: Under this category, health care providers, suppliers, and prescribers can be placed on the preclusion list if: The individual or entity has engaged in behavior for which CMS could have revoked the individual or entity to the extent applicable, if they had been enrolled in Medicare; and CMS determines that the underlying conduct that would have led to the revocation is detrimental to the best… [read post]
25 Sep 2017, 3:04 pm
” CMS is particularly interested in testing models in involving the following focus areas (although the Innovation Center may also test models in other areas): Increased participation in Advanced Alternative Payment Models under the Quality Payment Program. [read post]
1 Mar 2023, 9:29 am
It is in the best interest of all parties to ensure that the contract-level RADV appeals process is able to successfully process all RADV appeals. [read post]
14 Jan 2022, 2:25 pm
The majority concluded that CMS had the authority to issue the vaccine mandate rule under provisions in the Social Security Act that permit the agency to issue rules that “the Secretary finds necessary in the interest of the health and safety of individuals who are furnished services. . .. [read post]
15 Sep 2011, 6:57 am
In seeking guidance on these issues, the Finance Committee requested CMS [C]losely examine the physician ownership and investment interests presented by PODs and ensure that those are addressed as you finalize the reporting requirements of the Sunshine Act. [read post]
