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28 Jun 2017, 6:30 am
Case Study (Provided by Tower MSA Partners): 60% MSA Savings From CMS Re-Review Process CMS may increase prescription medication allocation in a WCMSA if there are inconsistencies in the medical records or the prescription histories, variances in pricing based upon the fluid movement of Redbook medication pricing, or prescription medications are left open-ended in the medical treatment records. [read post]
28 Jun 2017, 6:30 am
Case Study (Provided by Tower MSA Partners): 60% MSA Savings From CMS Re-Review Process CMS may increase prescription medication allocation in a WCMSA if there are inconsistencies in the medical records or the prescription histories, variances in pricing based upon the fluid movement of Redbook medication pricing, or prescription medications are left open-ended in the medical treatment records. [read post]
17 May 2017, 6:30 am
Importantly, CMS will not approve a Denied Claim Zero MSA if settlement is made final and/or a settlement payment or any medical or indemnity payment is made prior to CMS approval of the Zero MSA. [read post]
28 Feb 2011, 5:15 am
(NGS), the durable medical equipment (DME) Medicare administrative contractor for Jurisdiction B, inappropriately permitted $56.2 million in claims for CY 2007 for home blood-glucose test strips and/or lancet supplies used for diabetics. [read post]
17 Feb 2015, 3:14 pm
However, CMS recently introduced a new post-payment review system that requires RACs to review outpatient therapy claims using a new manual medical review process. [read post]
2 Mar 2015, 12:07 pm
In response, CMS reported that it is implementing an oversight plan of HHAs through the Supplemental Medical Review Contractor ("SMRC"), one of CMS's newest tools meant to ensure program integrity. [read post]
17 Aug 2020, 10:51 am
Allowing reimbursement for telehealth encourages patients to reduce the amount of in-person medical encounters, which in turn helps reduce the spread of COVID-19. [read post]
2 Aug 2010, 8:33 am
Accordingly CMS specifically would like the proposals from conveners to involve a diverse mix of physician practice sizes and types, medical specialties, and geographic areas. [read post]
21 Jun 2012, 6:14 am
CMS claimed this requirement would ensure continuity and regular communication between a hospital’s governing body and its medical staff – a goal that is particularly important in light of CMS’s decision to allow a single governing body for multi-hospital systems. [read post]
8 May 2012, 2:47 pm
On May 3, 2012, the Centers for Medicare and Medicaid Services (CMS) announced, via the CMS blog, that CMS will not require data collection by applicable manufacturers and group purchasing organizations under the Physician Payments Sunshine Act (PPSA) before January 1, 2013. [read post]
2 Feb 2022, 1:16 pm
” On January 20, 2022, CMS released updated guidance through its evolving “External FAQ: CMS Omnibus COVID-19 Health Care Staff Vaccination Final Rule. [read post]
7 Jan 2014, 10:05 am
In October 2011, CMS and the FDA formally launched a voluntary parallel review pilot program for sponsors of medical devices. [read post]
23 Apr 2012, 11:55 am
CMS has released a memo providing guidance to Part D sponsors and organizations interested in offering capitated financial alignment demonstration plans regarding contract year (CY) 2013 Medication Therapy Management (MTM) programs. [read post]
4 Dec 2013, 6:33 am
” - CMS – “[CMS] today released a final calendar year (CY) 2014 hospital outpatient and ambulatory surgical center (ASC) payment rule [CMS-1601-FC] that will give hospitals and ASCs new flexibility to lower outpatient facility costs and strengthen the long-term financial stability of Medicare. [read post]
21 Sep 2016, 8:34 am
” Noridian purports that this policy will help it to fulfill its obligations to the Centers for Medicare and Medicaid Services (CMS) by assuring that all Medicare claims are for medically necessary and reasonable services. [read post]
21 Sep 2016, 8:34 am
” Noridian purports that this policy will help it to fulfill its obligations to the Centers for Medicare and Medicaid Services (CMS) by assuring that all Medicare claims are for medically necessary and reasonable services. [read post]
13 Dec 2008, 12:04 am
Compromising of Future Medical Expenses-Does CMS compromise or reduce future medical expenses related to a [workers' compensation] injury? [read post]
24 May 2013, 2:27 pm
The General Services Administration issued a Request for Quotes (RFQ) seeking four A/B Recovery Auditors, one national Durable Medical Equipment auditor and one Home Health/Hospice Recovery Auditor. [read post]
5 Jul 2018, 2:41 am
Citing an interest in improving its processes and eliminating unnecessary requirements, CMS is hosting July 13, 2018 “Provider Compliance Focus Group” meeting regarding Medicare fee-for-service compliance topics, including medical review, targeted probe and educate, and Recovery Audit Contractors. [read post]
27 Oct 2017, 12:41 pm
A recent Office of Inspector General (OIG) report suggests that the lack of medical device-specific information on Medicare claim forms complicates CMS efforts to identify and track Medicare costs related to the replacement of recalled or prematurely failed medical devices. [read post]
