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9 Nov 2018, 8:04 am
The Centers for Medicare and Medicaid Services’ proposed IPI model also would replace the current “buy and bill” system for Part B drugs with a new drug distribution and billing model. [read post]
6 Nov 2018, 10:56 am
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and other private… [read post]
5 Nov 2018, 3:06 pm
The Centers for Medicare & Medicaid Services’ (CMS) final calendar year 2019 Medicare home health prospective payment system (HH PPS) rule boosts rates by 2.2% next year and ushers in broader case-mix methodology reforms for 2020. [read post]
2 Nov 2018, 1:03 pm
Earlier this summer the Centers for Medicare & Medicaid Services (CMS) published its Calendar Year (CY) 2019 home health agency (HHA) and home infusion therapy supplier payment updates proposed rule. [read post]
25 Oct 2018, 9:30 pm
Although Sachs recognizes that pharmaceuticals are a “fruitful avenue” for mental health treatments, data sharing between the National Institutes of Health (NIH) and the Centers for Medicare and Medicaid Services (CMS) would enhance mental health innovations beyond the pharmaceutical industry, she says. [read post]
24 Oct 2018, 11:55 am
Requires the Centers for Medicare & Medicaid Services (CMS) to develop guidance for hospitals on pain management and opioid use disorder prevention and to review Medicare quality measures related to opioids and opioid use disorders. [read post]
18 Oct 2018, 9:30 pm
HHS claimed the rule would help consumers “make informed decisions that minimize not only their out-of-pocket costs, but also unreasonable Medicare and Medicaid expenditures. [read post]
18 Oct 2018, 2:52 pm
The agenda also includes the anticipated timing of almost 200 pending and future HHS regulatory actions, the majority of which are Food and Drug Administration and Centers for Medicare & Medicaid Services regulations. [read post]
18 Oct 2018, 2:42 pm
The Centers for Medicare & Medicaid Services (CMS) has announced that 1,299 entities have signed agreements to participate in the Administration’s new Bundled Payments for Care Improvement (BPCI) Advanced episode payment model, which runs from October 1, 2018 through December 31, 2023. [read post]
17 Oct 2018, 1:39 pm
The Centers for Medicare & Medicaid Services (CMS) has proposed revising its rules governing the process Medicare beneficiaries, providers, and suppliers use to appeal adverse determinations regarding claims for Medicare Part A and Part B benefits or determinations for Part D prescription drug coverage. [read post]
17 Oct 2018, 6:33 am
Through these actions, the United States contended that ABC caused false claims to be submitted to the Centers for Medicare and Medicaid Services (“CMS”), the Department of Defense’s Defense Health Agency, which administers TRICARE, the Office of Personnel Management, which administers the Federal Employees Health Benefit Program, and the United States Department of Veterans Affairs (collectively, the “Federal Healthcare Payors”). [read post]
15 Oct 2018, 6:04 pm
The Anti-Kickback Statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. [read post]
11 Oct 2018, 3:36 am
The Department of Health and Human Services (HHS) has just announced annual inflation-related increases to civil monetary penalties (CMPs) in its regulations, including those promulgated by the Office of Inspector General, the Centers for Medicare & Medicaid Services, and the Food and Drug Administration. [read post]
10 Oct 2018, 6:45 am
” The legislation would require the Centers for Medicare and Medicaid Services to implement programs for prevention and treatment, and require the Food and Drug Administration “to update information on nonaddictive treatments for chronic pain and addiction,” among other measures. [read post]
8 Oct 2018, 2:25 pm
* * * The government further alleged that from September 2009 through December 2011, certain HMA hospitals submitted claims to Medicare and Medicaid seeking reimbursement for falsely inflated emergency department facility charges. [read post]
4 Oct 2018, 8:17 am
Home Health Providers Under the Microscope — The Review Choice Demonstration Project is Here(October 4, 2018): Last week, the Centers for Medicare & Medicaid Services (CMS), confirmed that it intends to initiate the Review Choice Demonstration for Home Health Services project on December 10, 2018. [read post]
24 Sep 2018, 10:00 am
., Board Certified by The Florida Bar in Health Law On June 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. [read post]
12 Sep 2018, 8:46 pm
In a press release revealed today, the Centers for Medicare & Medicaid Services (CMS) announced its efforts to provides American consumers with the ability to claim a hardship exemption from the tax penalty imposed by the ACA (Obamacare) for not maintaining health coverage for 2018 on their federal income tax returns, making it easier for taxpayers across the nation to claim their exemption. [read post]
11 Sep 2018, 2:49 pm
The H.R. 6690 bill, requires the Centers for Medicare & Medicaid Services (CMS) to establish a pilot program that evaluates the feasibility of using smart card technology to address Medicare fraud. [read post]
10 Sep 2018, 7:49 pm
Stamer has extensive health care reimbursement and insurance experience advising and defending plan sponsors, administrators, insurance and managed care organizations, health care providers, payers, and others about Medicare, Medicaid, Medicare and Medicaid Advantage, Tri-Care, self-insured group, association, individual and employer and association group a [read post]
