Search for: "US Department of Health and Human Services Center for Medicare & Medicaid Services"
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14 Apr 2023, 9:05 pm
Department of Health and Human Services (HHS), the Substance Abuse and Mental Health Services Administration (SAMHSA) aims to improve the quality and availability of treatment and rehabilitative services for behavioral health challenges. [read post]
13 Apr 2023, 8:41 am
The Medicare Act does not expressly provide for judicial review of overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
13 Apr 2023, 8:33 am
Note that OIG cautions that Centers for Medicare & Medicaid Services (CMS) may have their own take on these terms. [read post]
10 Apr 2023, 8:01 am
The Department of Health and Human Services Office of Inspector General (OIG) recently published a new frequently asked question (FAQ) and advisory opinion addressing how to analyze arrangements that may involve providing cash, cash equivalents, and/or gift cards to Medicare and/or Medicaid beneficiaries under the beneficiary inducements prohibition provision in the Civil Monetary Penalty Law (Beneficiary Inducements CMP) and Anti-Kickback… [read post]
30 Mar 2023, 7:10 am
The IRA has established a system in which the Department of Health and Human Services (HHS) will negotiate a pre-established list of drugs’ prices with the manufacturers over the next six years and beyond.[4] This negotiation process will subsequently change the reimbursement process for Medicare Part B and D providers. [read post]
30 Mar 2023, 7:10 am
The IRA has established a system in which the Department of Health and Human Services (HHS) will negotiate a pre-established list of drugs’ prices with the manufacturers over the next six years and beyond.[4] This negotiation process will subsequently change the reimbursement process for Medicare Part B and D providers. [read post]
21 Mar 2023, 6:07 am
Check with Medicare.gov: The Centers for Medicare & Medicaid Services (CMS) maintains a database of nursing homes that participate in Medicare and Medicaid. [read post]
17 Mar 2023, 2:51 pm
On February 28, 2023, six of the seven Medicare Administrative Contractors (MACs), who administer Medicare reimbursement on behalf of the Centers for Medicare and Medicaid Services (CMS), came together for a multijurisdictional contractor advisory committee (CAC) meeting. [read post]
16 Mar 2023, 1:14 pm
Check with Medicare.gov: The Centers for Medicare & Medicaid Services (CMS) maintains a database of nursing homes that participate in Medicare and Medicaid. [read post]
15 Mar 2023, 8:50 am
Department of Health and Human Services: $145.3 billion The budget request allocates more than $145 billion in discretionary funding to the Department of Health and Human Services (HHS), an 11.4 percent increase from the FY 2023 enacted level. [read post]
15 Mar 2023, 5:00 am
Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule to implement requirements of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). [read post]
7 Mar 2023, 7:56 am
Department of Health and Human Services (“HHS”) issued a report detailing the administrative hurdles CMS might face when implementing the Part B provisions. [read post]
3 Mar 2023, 10:17 am
The Justice Department alleges in court documents that, Brier, Bruining, and RCCA shortchanged Rhode Island and Massachusetts substance abuse disorder patients out of much needed counseling and treatment services, while defrauding Medicare, Medicaid, and other health insurers out of millions of dollars. [read post]
3 Mar 2023, 6:58 am
Department of Health and Human Services, Office of Inspector General. [read post]
1 Mar 2023, 9:29 am
This applies to both CMS RADV audits as well as Department of Health and Human Services Office of Inspector General (“OIG”) RADV audits. [read post]
23 Feb 2023, 5:00 am
Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. [read post]
23 Feb 2023, 4:00 am
On August 19, 2022 the Centers for Medicare and Medicaid Services announced plans to require nursing facilities to vaccinate most employees to continue to receive federal reimbursements. [read post]
9 Feb 2023, 1:15 pm
Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have taken initiative to “reduce the inappropriate use of antipsychotic medications and to bring greater transparency about nursing home citations to families. [read post]
8 Feb 2023, 10:04 am
Similarly, the withdrawal seems contrary to the Center for Medicare & Medicaid’s (“CMS’s”) push for ACOs, including the most recent ACO initiative, the ACO Realizing Equity, Access, and Community Health (“ACO REACH”). [read post]
8 Feb 2023, 7:59 am
Earlier Remand Generated Second Final Rule That earlier remand faulted the three agencies that authored the initial rule, The Centers for Medicare and Medicaid Services (CMS) the Internal Revenue Service (IRS) and Employee Benefits and Security Administration (EBSA), for using what the court saw as a de facto rebuttable presumption in favor of the QPA during the arbitration process and effectively putting a thumb on the scale in favor of… [read post]
