Search for: "CMS Health Care Provider"
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11 Oct 2023, 10:59 am
The Times Tribune reached out to local nursing homes, such as The Gardens at Scranton and Dunmore Health Care Center, for comment, but they declined to provide any statements on these issues. [read post]
10 Oct 2023, 10:51 am
Providers and suppliers can utilize AI to detect unusual billing patterns or anomalies that might suggest fraudulent activity, helping to prevent health care fraud. [read post]
9 Oct 2023, 8:15 pm
District Court for the District of Columbia has vacated the Notice of Benefits and Payment Parameters (NBPP) rule issued in May 2020 (2020 NBPP Rule) which allowed health insurers and pharmacy benefit managers to use copay accumulators to exclude drug manufacturers’ copay assistance when calculating patients’ out-of-pocket costs and cost-sharing ceilings under the Affordable Care Act (ACA). [read post]
5 Oct 2023, 9:35 am
On July 14, 2023, the commission voted to withdraw two of its prior statements on health-care antitrust, the 1996 “Statements of Antitrust Enforcement Policy in Health Care” and the 2011 “Statement of Antitrust Enforcement Policy Regarding Accountable Care Organizations Participating in the Medicare Shared Savings Program. [read post]
4 Oct 2023, 7:34 am
To ensure the payments accurately reflect the expected cost of providing health care to each beneficiary, CMS uses a process called “risk adjustment” to adjust payments based on the health status of enrollees. [read post]
3 Oct 2023, 2:59 pm
” “Medicare Advantage plans that submit false information to increase payments from CMS show blatant disregard for the integrity of these vital federal health care funds,” stated Christian J. [read post]
3 Oct 2023, 6:42 am
Department of Health and Human Services Office of Inspector General (HHS-OIG). [read post]
2 Oct 2023, 4:50 pm
Cigna relied on the results of those chart reviews to submit additional diagnosis codes to CMS that the healthcare providers had not reported for the beneficiaries to obtain additional payments from CMS. [read post]
2 Oct 2023, 12:34 pm
LinkedIn Health Care Risk Management & Operations Group, HR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy Group. [read post]
2 Oct 2023, 12:19 pm
LinkedIn Health Care Risk Management & Operations Group, HR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy Group. [read post]
2 Oct 2023, 11:57 am
LinkedIn Health Care Risk Management & Operations Group, HR & Benefits Update Compliance Group, and/or Coalition for Responsible Health Care Policy Group. [read post]
2 Oct 2023, 6:52 am
The Office of the Inspector General (OIG) for the Department of Health & Human Services (HHS) also provides voluntary self-disclosure protocols for institutions to report healthcare fraud. [read post]
2 Oct 2023, 5:00 am
In August 2023, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced its strategic plan to investigate the life cycle of Medicare and Medicaid managed care contracts. [read post]
29 Sep 2023, 4:26 pm
The appropriations process also provides funding for the Judicial Branch. [read post]
29 Sep 2023, 1:56 am
CMS has issued guidance allowing states to work with health plans, managed care organizations and community organizations to update enrollees’ information so they can stay enrolled. [read post]
27 Sep 2023, 9:27 am
If you have any questions about how to assist your patients or how the new rule could impact them, please reach out to the health care lawyers at Reed Smith. [read post]
26 Sep 2023, 5:10 pm
This questionnaire asks for key data points regarding recent self-disclosures made to the HHS Office of Inspector General via either the OIG’s Health Care Fraud Self-Disclosure Protocol (SDP) or the CMS Voluntary Self-Referral Disclosure Protocol (SRDP). [read post]
26 Sep 2023, 9:49 am
These establishments should adhere to CMS guidelines and continually train their staff to enhance the quality of care provided to residents. [read post]
25 Sep 2023, 5:18 am
This rule is a response to long-standing concerns about inadequate staffing negatively affecting the care provided to nursing home residents. [read post]
22 Sep 2023, 4:10 pm
In these environments, residents often face increased vulnerability due to various factors such as age, health, and cognitive decline. [read post]
