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19 Aug 2019, 4:09 am
The Centers for Medicare & Medicaid Services (CMS) is planning a potentially-significant overhaul of Medicare pricing rules for new items of durable medical equipment (DME), prosthetics, orthotics and supplies (DMEPOS) as part of its proposed annual DMEPOS policy update for calendar year (CY) 2020. [read post]
13 Apr 2023, 8:41 am
The Medicare Act does not expressly provide for judicial review of overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
27 Jan 2020, 11:20 am
Medicare fraud can occur anywhere As long as there exists a financial incentive for doctors and healthcare administrators to fraudulently charge for services they never rendered, or falsely inflate the cost of services to receive more money from the government, Medicare and Medicaid fraud will unfortunately continue to happen. [read post]
16 Feb 2022, 9:00 am
The Centers for Medicare & Medicaid Services (CMS) have recently released updated guidance regarding hospital co-locations arrangements. [read post]
24 Apr 2008, 2:19 pm
>Guidance released recently by the Centers for Medicare & Medicaid Services (CMS) sheds new light on an issue that has created hardships for beneficiaries and challenges for advocates trying to help them. [read post]
14 May 2007, 10:51 pm
More bad news for ESA drugs like Epogen:From the Medicare site:The Centers for Medicare & Medicaid Services (CMS) announced today its proposed decision to limit coverage of erythropoiesis stimulating agent (ESA) treatment for beneficiaries with certain cancers and related neoplastic conditions, either because of a deleterious effect of the ESA on the beneficiaries' underlying disease or because the underlying disease increases their risk of… [read post]
6 Apr 2016, 5:19 pm
The program is administered by the Centers for Medicare & Medicaid Services (CMS), and by private entities that contract with CMS to provide claims processing, auditing, and quality oversight services…” [read post]
5 May 2016, 6:06 pm
The Centers for Medicare & Medicaid Services (CMS) has proposed regulations to implement major reforms of the Medicare physician fee schedule (MPFS) update framework that were mandated by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). [read post]
31 May 2012, 4:55 am
The Centers for Medicare & Medicaid Services (CMS) published a final rule on May 29, 2012 that makes changes to Medicaid regulations regarding overpayments recoveries, state repayment of Medicaid disallowances, and other various policies. [read post]
29 Dec 2017, 3:23 pm
Attorneys Representing Injured Residents of Crescent Manor Rehabilitation Both the State of Vermont and the Centers for Medicare and Medicaid Services (CMS) conduct routine unannounced inspections and scheduled surveys on every nursing facility in the state. [read post]
19 Apr 2016, 9:21 am
The residential provider self-assessment is designed to enable the Texas Department of Aging and Disability Services (DADS) to evaluate the extent to which DADS regulations, standards, policies, licensing requirements, and other provider requirements comply with federal regulations issued by the Centers for Medicare & Medicaid Services (CMS). [read post]
24 Aug 2016, 9:00 am
Over the past several months, the Centers for Medicare & Medicaid Services (“CMS”) issued several final rules to update certain Medicare reimbursement rates and quality reporting requirements that impact vast numbers of healthcare providers. [read post]
3 Aug 2015, 1:30 am
" King introduced his bill in response to the July 8 announcement by the Centers for Medicare and Medicaid Services (CMS) to pay doctors to counsel patients about end-of-life care. [read post]
9 Mar 2020, 10:26 am
(March 6, 2020): Last September, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process. [read post]
7 Nov 2014, 6:38 am
Last week, the Centers for Medicare and Medicaid Services (CMS) issued the final Physician Fee Schedule for Fiscal Year 2015. [read post]
3 Nov 2015, 4:25 am
Today the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would modify the discharge planning conditions of participation (COPs) for hospitals, including long-term care hospitals and inpatient rehabilitation facilities, critical access hospitals, and home health agencies (HHAs). [read post]
12 Aug 2016, 6:31 am
The Centers for Medicare & Medicaid Services (CMS) has announced proposals for three new “episode payment models” that, like the Comprehensive Care for Joint Replacement (CJR) model, would mandate provider participation in selected geographic areas. [read post]
9 Jan 2018, 11:24 am
The Centers for Medicare & Medicaid Services (CMS) released Part I of the 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C Risk Adjustment Model and the use of encounter data. [read post]
7 Nov 2011, 12:22 pm
The Centers for Medicare and Medicaid Services have announced some key changes in qualifications for Medicaid long-term care benefits. [read post]
12 Jan 2018, 12:34 pm
The Centers for Medicare & Medicaid Services (CMS) [official website] on Thursday issued guidance [text, PDF; press release] that will allow states to require people to work as a condition to receiving Medicaid. [read post]
