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3 Feb 2016, 10:03 am
As also required under the FAR, OIG will calculate the total value of FAR contracts that CMS has not closed out and will seek to identify barriers to CMS managing and closing out FAR contracts. [read post]
16 Aug 2011, 5:16 am
About the Author: John Miano is the Manager of Reporting Services for Gould & Lamb, LLC. [read post]
19 Jan 2021, 8:43 pm
This legislation also permitted CMS to contract with eligible contractors to perform program integrity activities. [read post]
OIG Testimony Before Congressional Subcommittee Outlines Inadequacies of Medicaid Integrity Programs
19 Jun 2012, 7:47 am
Along with other tasks Review MICs are contracted to perform, they must provide or recommend audit leads to CMS. [read post]
28 Sep 2020, 8:58 am
“On-Site Review” as a Basis for a Home Health Revocation Action: In recent years, our attorneys have represented numerous home health agencies whose enrollment and Medicare billing privileges have been revoked due to the fact that an unannounced, on-site visit by a CMS-contracted inspector found that the provider was no longer operational to furnish Medicare covered home health services. [read post]
28 Sep 2020, 8:58 am
“On-Site Review” as a Basis for a Home Health Revocation Action: In recent years, our attorneys have represented numerous home health agencies whose enrollment and Medicare billing privileges have been revoked due to the fact that an unannounced, on-site visit by a CMS-contracted inspector found that the provider was no longer operational to furnish Medicare covered home health services. [read post]
5 Jul 2016, 10:21 am
Conclusion In sum, HHAs that provide home health services and physicians contracting with such HHAs and/or certifying the need for home health services should be wary of increased anti-fraud enforcement. [read post]
12 Jan 2012, 6:27 am
(Letter) HCSSA w/ DADS contract: DADS released the results of a joint streamlining project (with Access and Intake, Contract Oversight and Support, and Regulatory Services) conducted during fiscal year 2011. [read post]
10 Dec 2019, 4:02 pm
Total U.S. national healthcare spending in 2018 grew 4.6 percent according to a study conducted by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS). [read post]
18 May 2012, 1:14 pm
Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. [read post]
17 Nov 2010, 10:01 am
(BTW, they reserve the right to increase the fee if services of a case manager are required which in my experience almost always is the case). [read post]
23 Mar 2020, 1:28 pm
”[11] Currently, CMS will consider any individual with a condition identified as chronic in the list at section 20.1.2 of Chapter 16b of the Medicare Managed Care Manual to meet this criteria. [read post]
11 Nov 2013, 9:40 am
– HHSC will host a series of information sessions about several Medicaid managed care initiatives scheduled for September 1, 2014, which will cover STAR+PLUS expansion to rural areas and the delivery of various services through managed care. [read post]
26 Dec 2013, 5:53 pm
Her widely respected publications and programs include more than 25 years of publications on health plan contracting, design, administration and risk management including a “Managed Care Contracting Guide” published by the American Health Lawyers Association and numerous other works on vendor contracting. [read post]
20 Apr 2015, 9:11 am
CMS Contract Management Services, Inc. [read post]
30 Aug 2012, 6:15 am
The WCRC contract has onerous service requirements and, without the money to staff the contract, 203 day backlogs are what you get. [read post]
20 Jul 2017, 4:34 am
Agents and brokers planning to market health insurance coverage sold through the health care marketplaces established under the Patient Protection and Affordable Care Act (ACA) should register and participate in one of the upcoming “Plan Year 2018 Registration & Training Overview For Agents and Brokers” sessions offered by the Centers for Medicare & Medicaid Services (CMS) to: Provide Registration and training information for Plan Year (PY) 2018; and Answer… [read post]
29 Nov 2023, 5:04 pm
This measure, together with new pharmacy contracting requirements and related enforcement provisions also included in the bill, would represent an important—albeit limited—modification to pharmacy network contracting rules under Part D, which have been limited by the statutory “non-interference clause” barring the Centers for Medicare and Medicaid Services (CMS) from interfering in contract negotiations between pharmacies and plans… [read post]
3 Jul 2018, 9:00 am
Virtually all of these private sector companies have previously been awarded one or more prior CMS audit contracts. [read post]
1 Jul 2020, 1:06 am
In this case comment, Adrian Bell, Nigel Lewis, Steven Bell and Shona Frame, all partners within the CMS Infrastructure, Construction and Energy Disputes Group, comment on the decision handed down in June 2020 in the matter of Bresco Electrical Services Ltd (in liquidation) v Michael J Lonsdale (Electrical) Ltd [2020] UKSC 25: The Supreme Court has overturned a Court of Appeal decision heavily limiting the ability of insolvency practitioners to commence and… [read post]
