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4 Nov 2022, 7:04 am
” The U.S. alleges that ModMed customers who received EHR donations “submitted tainted claims for reimbursement to the federal health care programs for pathology services performed by Miraca from January 2010 to December 2013, and also submitted tainted claims for meaningful use incentive payments under the Medicare and Medicaid Electronic Health Record Incentive Programs…of the Centers for Medicare and Medicaid… [read post]
3 Nov 2022, 9:05 pm
Centers for Medicare & Medicaid Services finalized a rule that adjusts payment rates for physicians providing behavioral health services. [read post]
2 Nov 2022, 1:39 pm
In the 2023 Outpatient Prospective Payment System Final Rule (OPPS Final Rule), released in pre-publication form on November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) adopts final regulations governing REHs. [read post]
2 Nov 2022, 5:00 am
As many healthcare providers may know, UPICs are the primary program integrity contractors for the Centers for Medicare & Medicaid Services (CMS) and the only program integrity contractors with authority to review both Medicare and Medicaid claims. [read post]
1 Nov 2022, 2:20 pm
Although not available statewide, this program offers out-of-home daytime care and supervision at designated CBAS centers. [read post]
31 Oct 2022, 11:35 am
According to the press release, Oswego Hospital alleged that it “improperly bill[ed] Medicare and Medicaid for outpatient mental healthcare services that were rendered by an unsupervised LMSW” and “improperly bill[ed] Medicaid for outpatient mental healthcare services rendered by another LMSW for which Oswego Hospital could not provide documentation to support those claims. [read post]
27 Oct 2022, 9:05 pm
The Centers for Medicare & Medicaid Services (CMS) imposed stricter accountability standards on nursing homes with a history of poor performance. [read post]
26 Oct 2022, 1:17 pm
Stronger implementation of the “Special Focus Facilities (SFF) program” will occur by the Centers for Medicare and Medicaid Services. [read post]
26 Oct 2022, 5:00 am
The following month, in July 2022, the Centers for Medicare & Medicaid (CMS) issued a guidance reiterating federal obligations placed on hospitals and health care providers by EMTALA. [read post]
24 Oct 2022, 12:10 pm
In 2021, for example, thirteen percent (800,000) of" "LIS enrollees were expected to pay an average of $27/month for Part D premiums in plan year 2022 if they did not switch to a premium free plan.In many cases, the reason these individuals are paying premiums is inertia.People who qualify for the full Medicare Part D LIS do not pay premiums if they enroll in plans with “benchmark” prescription drug premiums.Benchmark plans have premiums at or below a cut-off in each… [read post]
24 Oct 2022, 12:08 pm
The Centers for Medicare and Medicaid Services (CMS) announced last Friday that it’s bolstering scrutiny for chronically under-performing nursing homes through revisions of its Special Focus Facility Program. [read post]
20 Oct 2022, 9:47 pm
Department of Health and Human Services, through the Center for Medicare & Medicaid Services, approved Arizona’s proposed Medicaid demonstration which plans to target health-related social needs such as housing support services. [read post]
20 Oct 2022, 7:05 pm
Department Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a Request for Information (RFI) on October 7, 2022, seeking input on creation of a national provider directory for use by patients, regulators, and insurers. [read post]
20 Oct 2022, 9:04 am
In addition, recipients of federal Medicare and Medicaid funding remain obligated under the federal Centers for Medicare & Medicaid Services (CMS) interim final rule, which was upheld by the Supreme Court of the United States early this year. [read post]
18 Oct 2022, 1:58 pm
The Centers for Medicare and Medicaid Services (CMS) is responsible for enforcing EMTALA. [read post]
17 Oct 2022, 3:04 pm
The Centers for Medicare and Medicaid Services (CMS) pay Medicare Advantage plans monthly and give more money to companies that care for sicker people. [read post]
17 Oct 2022, 5:00 am
The UPIC may also persuade the Centers for Medicare & Medicaid Services (CMS) to revoke the provider’s Medicare billing privileges because the UPIC’s probe audits have made it appear as though the provider has a pattern of submitting claims that do not meet Medicare requirements. [read post]
14 Oct 2022, 1:07 pm
California Indian Legal Services Staff Attorney. [read post]
10 Oct 2022, 5:01 am
Civil Investigative Demands are often at the center of the government’s investigative efforts prior to deciding whether to intervene in a qui tam. [read post]
5 Oct 2022, 10:25 am
United States Department of Health and Human Services case arose from a 2019 Centers for Medicare & Medicaid Services (CMS) rule prohibiting nursing homes from requiring residents to sign binding arbitration agreements. [read post]
