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22 Feb 2023, 7:17 am
The Centers for Medicare & Medicaid Services (CMS) recently issued a Medicare-related final rule invoking the agency’s statutory authority to promulgate retroactive rules after finding that failure to apply the final rule retroactively would be “contrary to the public interest. [read post]
27 Apr 2023, 11:35 am
In part I, we discussed whether federal district courts could exercise jurisdiction under the federal-question statute over legal challenges to 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]
2 Aug 2019, 2:17 pm
On August 2, 2019, the Centers for Medicare & Medicaid Services (CMS) published its Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Care Acute Care Hospital (LTCH) Prospective Payment System (PPS) final rule (CMS-1716-F). [read post]
14 Jul 2009, 5:20 pm
The Centers for Medicare and Medicaid Services (”CMS”) awarded a contract for this study to Research Triangle Institute International (”RTI”), which was previously awarded a contract in 2005 to evaluate the feasibility of developing patient and facility level characteristics for LTACHs that could distinguish LTACH patients from those treated in other acute care settings. [read post]
27 May 2022, 3:51 pm
On April 29, 2022, the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). [read post]
14 May 2012, 8:41 am
On May 11, 2012, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2013. [read post]
12 May 2024, 12:28 pm
Nursing homes and other health care facilities competing for staffing with these facilities should begin preparing to cope with expected wage costs and other pressures expected to result from new staffing and other changes to staffing requirements for Meficare and Medicaid participating long-term care favorites released by the Department of Health and Human Services Centers for Medicare & Medicaid Services (“”CMS”) on April… [read post]
30 Aug 2012, 1:05 pm
In light of all this confusion, the Centers for Medicare and Medicaid Services (“CMS”) recently announced that it was considering enacting new regulations to clarify when MSAs are required in personal injury liability cases. [read post]
30 Nov 2009, 11:14 am
Last Wednesday the Centers for Medicare and Medicaid Services (“CMS”) published the final rule (subject to comment period) for the 2010 Medicare Physicians’ Fee Schedule. [read post]
7 Apr 2009, 12:02 pm
Calderone, Director and Chief Judge of the NJ agency issued a Memorandum in an effort to establish a formalized and smooth transition with the integration of the mandatory reporting requirements to be initiated this year by The Centers for Medicare and Medicaid Services (CMS).1. [read post]
30 Sep 2011, 6:56 am
As part of the Centers for Medicare & Medicaid Service (CMS) efforts to continuously improve its Medicare Secondary Payer (MSP) program; CMS has posted the following information to the MSP websites: 1) An ALERT delaying the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) Section 111 MSP reporting requirement for certain liability insurance (including self-insurance) settlements, judgments, awards, or other payments… [read post]
3 Feb 2011, 8:39 am
Berwick, administrator of the Centers for Medicare and Medicaid Services (”CMS”), indicated that a proposal outlining the Obama administration’s preferred ground rules for new accountable care organizations should be out within a month. [read post]
7 Mar 2023, 7:56 am
On February 9, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued a fact sheet and its initial guidance documents addressing the Medicare Prescription Drug Inflation Rebate Program for Medicare Parts B and D (the “Inflation Rebates”)—a critical component of the sweeping prescription drug pricing changes enacted through the Inflation Reduction Act of 2022 (the “IRA”). [read post]
21 Nov 2016, 2:46 pm
The Centers for Medicare & Medicaid Services (CMS) has issued its final Medicare physician fee schedule (MPFS) for calendar year (CY) 2017. [read post]
19 Feb 2009, 1:14 am
Department of Health and Human Services, Centers for Medicare and Medicaid Services (“CMS”), published final rules regarding payment limitations on diagnostic testing and the application of the “anti-markup” rules for diagnostic imaging services (the “2009 Rules”). [read post]
18 Oct 2021, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) announced that it had restarted the Targeted Probe and Educate (TPE) audit process, effective September 1, 2021. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
22 Feb 2023, 10:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued a final rule on the use of extrapolation to determine overpayments in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs) and for audits conducted by the Office of Inspector General (OIG), effective for payment year 2018. [read post]
10 Nov 2022, 10:00 pm
The Centers for Medicare & Medicaid Services (CMS) delayed the publication of the final rule on the use of extrapolation and the application of a fee-for-service adjuster (FFS Adjuster) in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs). [read post]
10 Nov 2022, 10:00 pm
The Centers for Medicare & Medicaid Services (CMS) delayed the publication of the final rule on the use of extrapolation and the application of a fee-for-service adjuster (FFS Adjuster) in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs). [read post]
