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18 Oct 2011, 4:40 am by Jerri Lynn Ward, J.D.
Finally, HHSC intends to submit to CMS a request to renew the TxHmL waiver program. [read post]
16 Jul 2018, 12:47 pm by Robert Liles
 UPIC reviews of transcranial magnetic stimulation claims.UPICs are private, for-profit companies that awarded contracts to provide program integrity services for the Centers for Medicare and Medicaid Services (CMS). [read post]
9 May 2013, 6:02 am by Jon Gelman
The portal must also provide supplier or provider names, diagnosis codes, dates or service, and conditional payment amounts. [read post]
4 Mar 2014, 9:51 am by Cynthia Marcotte Stamer
The Centers for Medicare & Medicaid Services (CMS) has revised its guidance in its Non-Group Health Plan (NGHP) User Guide to clarify the reporting threshold for certain liability (including Self-Insurance) Settlements, Judgment Awards, or other Payments under the provisions of the Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007, 42 U.S.C. 1395y(b)(7)&(b)(8) (the “Secondary Payer… [read post]
6 Jan 2011, 10:11 am
The suit names the city and a contractor, Correctional Medical Services, as defendants along with Eugene Stubblefield, the jail superintendent, and two CMS physicians, Drs. [read post]
6 May 2013, 6:00 am by Rebecca Shafer, J.D.
    The most popular workers compensation abbreviations include:   AWW Average weekly wage – the average earnings of an employee based on a set number of weeks (or months) prior to the injury   C Claimant – the injured employee   Clmt: Claimant   CMS: Centers for Medicare and Medicaid Services – the federal government agency that oversees the Medicare and Medicaid programs   CMS: Claim management system… [read post]
6 Apr 2012, 12:06 pm
Medical documentation will be reviewed to determine that services were medically necessary. [read post]
3 Oct 2014, 6:30 am by Senior Editor
Broadspire is a leading global third-party administrator of workers compensation claims, liability claims and medical management services. [read post]
29 Aug 2017, 4:41 am by Cynthia Marcotte Stamer
See The HHS Centers for Medicare & Medicaid Services’ (CMS) beneficiaries and their health care providers greater flexibility to provide Medicare-covered health care to meet emergency health needs under his authority in the Public Health Service Act and Social Security Act. [read post]
19 Aug 2022, 1:36 pm by Jonathan Schall
The new law expands the list of procedures that are allowed to be performed in Pennsylvania ASCs by aligning that list with those procedures contained in the 2022 Ambulatory Surgical Center Covered Procedures List (“ASC-CPL”) published by the Centers for Medicare and Medicaid Services (“CMS”). [read post]
14 Jan 2013, 7:55 am by Debra A. McCurdy
 Major Department of Health and Human Services (HHS) regulations are highlighted after the jump.An HHS Office of Inspector General (OIG) proposed rule that would add new/modify existing safe harbors under the anti-kickback statute; add new/revise existing regulations governing OIG's authority to impose civil money penalties and assessments; add new/revise existing regulations governing OIG's exclusion authority; and codify new exceptions to the beneficiary inducement prohibition… [read post]
10 May 2011, 8:08 am by Medicare Set Aside Services
The Centers for Medicare and Medicaid Services (CMS) was requested to approve the LMSA, but no substantive response has been received for at least 60 days from the date of the letter to CMS; and  d. [read post]
30 Sep 2014, 6:30 am by Jacob Lazarovic, M.D.
”   The Centers for Medicare & Medicaid Services (CMS) has taken the lead in establishing a program of this type:   “On January 31, 2013, the Centers for Medicare & Medicaid Services (CMS) announced the health care organizations selected to participate in the Bundled Payments for Care Improvement initiative, an innovative new payment model. [read post]
10 Apr 2014, 9:10 am by Debra A. McCurdy
While attention has been focused on Medicare physician payment data released by CMS yesterday, upcoming Sunshine Act data will shine a new spotlight on financial relationships between physicians and pharmaceutical and medical device companies – with potential FCA implications.Last week marked the deadline for pharmaceutical and medical device manufacturers and group purchasing organizations (GPOs) to register with and submit aggregate 2013 payment and investment… [read post]
19 Aug 2015, 7:28 am
The Centers for Medicare and Medicaid Services ("CMS") and the Office of Inspector General ("OIG") have taken several steps recently to crack down on what it views as abusive PODs and POHs. [read post]
4 Dec 2011, 10:00 am by Ray Mullman
State survey and certification agencies check complaints and are supposed to report them to the Centers for Medicare and Medicaid Services (CMS). [read post]
27 Nov 2018, 6:40 am by The Health Law Partners
A list of the telehealth services that are currently covered by CMS can be found here. [read post]
13 Sep 2009, 6:10 pm
Furthermore, the OIG found that the services hospices most commonly furnished included nursing services (96% of claims), home health aide (73% of claims), and medical social services (68% of claims). [read post]
12 Oct 2011, 11:33 am by Lisa Baird
On Friday, October 7, 2011, the Centers for Medicare & Medicaid Services ("CMS") and the Food and Drug Administration ("FDA") (collectively, the "Agencies") announced they were soliciting nominations from sponsors of medical devices to participate in the Agencies’ parallel review pilot program. [read post]
27 Jun 2013, 2:52 pm
In 2010, the Center for Medicare and Medicaid Services (CMS) reported that nearly 17 percent of nursing home residents were receiving antipsychotic medications that exceeded recommended levels on a daily basis. [read post]