Search for: "Administrator for the Centers for Medicare and Medicaid Services"
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27 Aug 2019, 4:13 am
It includes home care, including by family members, assisted living facilities, nursing homes, adult day care centers, and continuing care communities. [read post]
17 Aug 2019, 11:56 am
In this case, a well-respected state university health science center filed a self-disclosure with the OIG for submitting claims to Medicare using the NPIs of multiple physicians who did not render or supervise the services at issue. [read post]
14 Aug 2019, 8:26 am
The Centers for Medicare & Medicaid Services (CMS) has published its proposed Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) rates and policies for calendar year 2020. [read post]
13 Aug 2019, 1:28 pm
While the Centers for Medicare and Medicaid Services (CMS) has been fairly progressive in approving the coverage of certain genetic tests for diagnostic purposes, it has been slow to authorize the coverage of genetic screening tests. [read post]
6 Aug 2019, 11:14 am
Murphy’s article Judicial Deference, Agency Commitment, and Force of Law is cited in the following article: Brooke Ferenczy, The Failure of the Tenth Circuit to Address the Due Process Concerns Raised by the Centers for Medicare and Medicaid Services’ Increasing Regulations, 13 Liberty U. [read post]
5 Aug 2019, 8:00 am
Chronis argued on appeal that she had exhausted her administrative remedies by submitting a letter to the Centers for Medicare and Medicaid Services (CMS), but the U.S. [read post]
31 Jul 2019, 9:14 am
This year, key information regarding the Appropriate Use Criteria (AUC) program is being released by the Centers for Medicare & Medicaid Services (CMS) via guidance documents. [read post]
29 Jul 2019, 10:52 am
Among their concerns are Fees for MSA preparation MSA professional administration Cost of the MSA Requirements to obtain additional medical documentation Time involved Submitting the MSA to the Centers for Medicare and Medicaid Services Failed settlements due to rejected MSAs For injured workers, their concerns about MSAs may be the biggest thing keeping them from settling their claims. [read post]
26 Jul 2019, 9:34 am
According to the Centers for Medicare & Medicaid Services (CMS), a “Medicare Set-Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a … settlement to pay for future medical services related to the … injury, illness, or disease. [read post]
19 Jul 2019, 7:21 am
This week, the Centers for Medicare & Medicaid Services (CMS) proposed to cover acupuncture for Medicare patients with chronic low back pain who are enrolled participants either in clinical trials sponsored by the National Institutes of Health (NIH) or in CMS-approved studies. [read post]
16 Jul 2019, 2:01 pm
Stamer’s clients include employers and other workforce management organizations; employer, union, association, government and other insured and self-insured health and other employee benefit plan sponsors, benefit plans, fiduciaries, administrators, and other plan vendors; domestic and international public and private health care, education and other community service and care organizations; managed care organizations; insurers, third-party administrative… [read post]
16 Jul 2019, 8:00 am
The report gave rise to a response from the administrator of the Center for Medicare and Medicaid Services (CMS), Seema Verma, who stated that the Center for Medicare and Medicaid Services does not tolerate abuse and mistreatment of nursing home patients and has in the past slapped significant fines on nursing homes that failed to report cases. [read post]
15 Jul 2019, 11:41 am
The Centers for Medicare & Medicaid Services (CMS) has proposed rescinding current procedural standards that must be met for states to demonstrate that Medicaid fee-for-service (FFS) payments are sufficient to assure beneficiary access to covered services. [read post]
10 Jul 2019, 3:33 pm
Stamer’s clients include employers and other workforce management organizations; employer, union, association, government and other insured and self-insured health and other employee benefit plan sponsors, benefit plans, fiduciaries, administrators, and other plan vendors; domestic and international public and private health care, education and other community service and care organizations; managed care organizations; insurers, third-party administrative… [read post]
1 Jul 2019, 11:27 am
The government reduced its payment rates this year by about 4 percent per enrollee because of changes in federal laws passed in 2006 and 2008, according to the Centers for Medicare and Medicaid Services. [read post]
19 Jun 2019, 8:34 am
On June 17, 2019, the Centers for Medicare & Medicaid Services (CMS) announced a settlement option for certain IRF appeals pending at any of the four fee-for-service Medicare administrative appeals levels: the Medicare Administrative Contractor (MAC), qualified independent contractor (QIC), the Office of Medicare Hearings and Appeals (OMHA) Administrative Law Judge (ALJ), and/or the… [read post]
19 Jun 2019, 7:13 am
United States—a pre-award bid protest handled by Crowell & Moring—the Federal Circuit ruled that “workload caps” imposed by the Centers for Medicare & Medicaid Services (“CMS”) in its administration of the Medicare Program violated the Competition in Contracting Act’s (“CICA”) “full-and-open competition” requirement. [read post]
6 Jun 2019, 3:55 pm
As part of its continuing “Patients over Paperwork” initiative, the Centers for Medicare & Medicaid Services (CMS) has released another request for information (RFI) on regulatory or subregulatory changes the agency could make to “reduce unnecessary administrative burdens for clinicians, providers, patients and their families. [read post]
4 Jun 2019, 2:38 pm
In 2003, the Centers for Medicare and Medicaid Services (“CMS”) proposed a rule that excluded Medicare Part C beneficiaries from the calculation of the Medicare fraction. [read post]
4 Jun 2019, 10:35 am
In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers. * * * [read post]
