Search for: "CMS MEDICARE CLAIMS OFFICE"
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24 Jun 2010, 6:43 am
On June 14, 2010, CMS published a report entitled, "The Medicare Recovery Audit Contractor (RAC) Program: Update to the Evaluation of the 3-Year Demonstration Program. [read post]
13 Dec 2022, 5:00 am
CMS, its contractors, and other federal agencies, such as the Department of Health and Human Services (HHS) Office of Inspector General (OIG), have used statistical extrapolation against Medicare providers for decades, while strong opposition from the insurance industry has kept it from being applied to audits of MA plans. [read post]
25 Apr 2014, 11:49 am
As part of the Obama Administration's efforts to make Medicare more transparent, CMS has prepared a public data set providing information on services and procedures provided to Medicare beneficiaries under Medicare Part B. [read post]
4 Nov 2014, 2:31 pm
On October 29th, the Office of Medicare Hearings and Appeals (OMHA) hosted its second Appellant Forum in Washington, D.C. [read post]
24 Jul 2013, 1:58 pm
In our recent blog post, CMS Issues Demand Letters to Providers and Suppliers with Claims for Services Provided to Allegedly Incarcerated Beneficiaries, we discussed the large number of demand letters CMS released regarding Medicare overpayments for incarcerated beneficiaries. [read post]
25 Apr 2013, 12:14 pm
CMS states in the preamble that it proposes to clarify that it will not pay an award if the same or substantially similar information was the basis for a relators share in a qui tam lawsuit under the federal False Claims Act or a state False Claims Act, or is the basis for a pending state or federal False Claims Act suit. [read post]
26 Apr 2013, 9:25 am
CMS states in the preamble that it proposes to clarify that it will not pay an award if the same or substantially similar information was the basis for a relators share in a qui tam lawsuit under the federal False Claims Act or a state False Claims Act, or is the basis for a pending state or federal False Claims Act suit. [read post]
14 Nov 2013, 2:31 am
First, despite safeguards intended to prevent and recover Medicare payments made on behalf of deceased beneficiaries, Medicare inappropriately paid $23 million in 2011 for claims with service dates after beneficiaries' deaths. [read post]
23 Aug 2010, 2:43 am
Under Part D, plan sponsors are required to submit Prescription Drug Event (PDE) data to the Centers for Medicare and Medicaid Services (CMS) for each claim submitted. [read post]
21 Nov 2016, 2:46 pm
The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. [read post]
22 Mar 2020, 1:21 pm
On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare telehealth services to allow Medicare patients to receive more services from their doctors without travel to a health care facility. [read post]
8 Sep 2014, 6:06 am
The Government Accountability Office (GAO) has issued a report entitled “Medicare Program Integrity: Increased Oversight and Guidance Could Improve Effectiveness and Efficiency of Postpayment Claims Reviews. [read post]
26 Jun 2017, 9:03 am
Briefly, Centers for Medicare and Medicaid Services (“CMS”) must remove Social Security Numbers (“SSNs”) from all Medicare cards. [read post]
17 Nov 2015, 4:29 am
The Office of Inspector General (OIG) and CMS also jointly announced waivers of certain specified fraud and abuse laws for specified arrangements involving CJR model participants. [read post]
31 Aug 2023, 1:02 pm
This change reflects the CMS Office of the Actuary’s use of updated estimates and data in its projections. [read post]
19 Nov 2023, 11:35 am
NGHP includes workers’ compensation claims. [read post]
2 Jun 2016, 12:14 pm
The HHS Office of Inspector General (OIG) and the Government Accountability Office (GAO) have recently examined a number of Medicare and Medicaid provider screening and related program integrity issues. [read post]
31 May 2012, 11:59 am
CMS will publish CBRs that analyze Medicare Part B final claims data from January 1, 2011 through December 31, 2011. [read post]
27 Aug 2013, 8:58 am
The HHS Office of the Inspector General (OIG) has issued a report entitled “Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Elective Surgeries. [read post]
31 Jan 2010, 3:00 pm
The Regional Offices (RO) of CMS will not approve work comp claim settlements agreeing not to bill Medicare for future work comp related medical care. 3. [read post]
