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20 Mar 2024, 10:00 pm
Part B covers certain physician services, outpatient care, medical supplies, and preventive services. [read post]
20 Mar 2024, 10:00 pm
Part B covers certain physician services, outpatient care, medical supplies, and preventive services. [read post]
20 Mar 2024, 10:00 pm
Part B covers certain physician services, outpatient care, medical supplies, and preventive services. [read post]
20 Mar 2024, 10:00 pm
Part B covers certain physician services, outpatient care, medical supplies, and preventive services. [read post]
20 Apr 2015, 8:00 am
Preventing Theft and Misuse of Physician Medical Identifiers CMS further suggests that providers take active steps to protect their medical identifiers. [read post]
23 Apr 2019, 9:01 am
The MAOs, in turn, submitted the diagnosis codes to CMS from the beneficiaries’ medical encounters, such as office visits and hospital stays. [read post]
22 Mar 2020, 9:13 pm
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]
20 Dec 2016, 5:00 am
CMS also adopted provisions related to, among many other things: the risk adjustment data validation process; the premium adjustment percentage; limits on cost-sharing; standardized plan options; enrollment periods and options; oversight; changes to child age rating; revisions to the guaranteed renewability regulations related to market withdrawals; and medical loss ratio reporting and rebates. [read post]
20 Jun 2013, 12:41 pm
The Centers for Medicare and Medicaid Services (CMS) contracts with sponsors that provide drug coverage to beneficiaries enrolled in Medicare Part D. [read post]
17 Apr 2009, 6:48 am
Recently, the Centers for Medicare and Medicaid Services (CMS) laid out new rules for private insurers that wish to bid for the right to offer Medicare Advantage (private comprehensive medical coverage) and Medicare Part D (prescription drug) plans. [read post]
13 Nov 2007, 1:47 pm
L. 109-432 (MIEA-THRCA) requires the Secretary of Health and Human Services to develop measures to make it possible to assess the quality of care (including medication errors) furnished by hospitals in outpatient settings. [read post]
11 Nov 2013, 2:03 pm
Under the “Sunshine Act” provisions of the Affordable Care Act, certain manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid and CHIP must report annually to the Department of Health and Human Services (HHS) certain payments or transfers of value they have made to physicians and teaching hospitals. [read post]
14 May 2012, 8:13 am
The rule also allows CAHs to provide certain diagnostic and therapeutic services, including laboratory and radiology services and emergency procedures, under arrangement (rather than directly by CAH staff). [read post]
30 Jan 2014, 7:02 am
The OIG focused on LCDs issued by MACs for Part B items and services performed by noninstitutional providers (e.g., medical procedures, evaluation and management services, imaging services, drugs, and tests), but excluded LCDs for durable medical equipment. [read post]
16 Apr 2014, 6:24 am
By way of background, CMS published a final rule on February 2, 2011 pursuant to Section 640 of the ACA, which required the Department of Health and Human Services to establish procedures for screening providers and suppliers participating in federal health care programs (specifically, Medicare, Medicaid, and the Children’s Health Insurance Program). [read post]
3 Dec 2013, 2:19 pm
This provision is effective for services furnished on or after April 1, 2014. [read post]
13 Aug 2013, 3:54 pm
There are two main aspects of the 2014 IPPS Final Rule that will significantly affect the day-to-day operations of hospitals nationwide: First, the 2014 IPPS Final Rule finalizes CMS' proposal to revise its "Payment Denial Policy" and allow billing of many services under Part B following a determination that a Part A inpatient claim will be denied as not medically necessary. [read post]
8 Jan 2014, 8:44 am
Upcoming CMS events will focus on Medicare inpatient hospital admission and medical review criteria, the Medicare ESRD Quality Incentive Program, new medical services and technologies under the Medicare hospital inpatient prospective payment system, and hospital outpatient services, and the HHS Office of Medicare Hearings and Appeals is hosting a Medicare Appellant Forum. [read post]
10 Dec 2013, 1:01 pm
Upcoming CMS events will focus on Medicare physician quality reporting, new medical services and technologies under the Medicare hospital inpatient prospective payment system, and hospital outpatient services. [read post]
6 Dec 2011, 4:19 pm
Final Rules Make Direct Access To Data By All But Most Sophisticated Impossible The Centers For Medicare & Medicaid Services (“CMS”) says disclosures of certain Medicare provider and supplier claims performance data scheduled to begin in January will empower employers, health plans and consumers to better evaluate the quality of these health care providers and suppliers. [read post]
