Search for: "US Department of Health and Human Services Center for Medicare & Medicaid Services"
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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]
8 Feb 2023, 5:39 am
The people sent us a clear message. [read post]
7 Feb 2023, 12:00 pm
The Department of Health and Human Services (“HSS”) arguably did just that in promulgating its rule specifying the administrative dispute resolution (“ADR”) process[1] for conflicts between drug makers and certain health care providers. [read post]
2 Feb 2023, 1:45 pm
On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. [read post]
17 Jan 2023, 11:09 am
Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). [read post]
12 Jan 2023, 9:05 pm
” The Centers for Medicare and Medicaid Services (CMS) announced its plan to implement a Medicare drug pricing negotiation program, which will set maximum fair price ceilings, as authorized by the Inflation Reduction Act. [read post]
26 Dec 2022, 4:00 pm
Establishes a “good faith” reporting requirement for RxDC reporting submitted for the 2020 and 2021 calendar years, whereby the Departments will not take enforcement action against a plan or issuer that completes the filings using a good faith, reasonable interpretation of the RxDC reporting interim final regulations published on November 23, 2021 and the RxDC Reporting Instructions issued by the Centers for Medicare and Medicaid… [read post]
15 Dec 2022, 5:56 pm
The prosecution of the suit against a health care organization subject to the tightest vaccination and other COVID safety mandates under Centers for Disease Control, the Centers for Medicare & Medicaid Services and Occuoatiinal Safety & Health Administration regulations demonstrates the high burden the EEOC expects employers refusing accommodation to meet. [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]
11 Nov 2022, 9:22 am
Robbins responded that private litigation is antithetical to the substantial enforcement power and discretion FNHRA accords states and the secretary of health and human services. [read post]
4 Nov 2022, 10:51 am
Department of Health and Human Services that will require regular monitoring of its billing practices for a period of three years.Dr. [read post]
3 Nov 2022, 9:05 pm
Centers for Medicare & Medicaid Services finalized a rule that adjusts payment rates for physicians providing behavioral health services. [read post]
2 Nov 2022, 5:00 am
On October 3, 2022, the US Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report detailing OIG’s findings related to the efficacy of the Unified Program Integrity Contractor (UPIC) program. [read post]
