Search for: "Administrator for the Centers for Medicare and Medicaid Services"
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21 Jul 2023, 9:01 am
On June 22, 2023, the Centers for Medicare & Medicaid Services (CMS) announced its proposed “Transitional Coverage for Technologies” (TCET) pathway—the Biden administration’s highly anticipated take on a mechanism to expedite coverage for certain devices designated by the U.S. [read post]
16 Jul 2023, 10:41 pm
WCAB panel decisions are citeable authority, particularly on issues of contemporaneous administrative construction of statutory language. [read post]
5 Jul 2023, 5:46 am
On June 6, 2023, the Center for Medicare and Medicaid Services (“CMS”) released a Quality Safety & Oversight memorandum (“QSO Memo”) reminding state survey agencies, accrediting organizations, and hospitals of the requirements for discharges and transfers to post-acute care (“PAC”) providers. [read post]
5 Jul 2023, 5:00 am
The Centers for Medicare & Medicaid Services (CMS) recently announced the start of a new skilled nursing facility (SNF) 5 Claim Probe & Educate Review Program (SNF P&E Program). [read post]
20 Jun 2023, 5:55 am
COVID-19 Vaccine Mandate Update (June 20, 2023): In response to the recent public health crises, the Centers for Medicare & Medicaid Services (CMS) first implemented a vaccine mandate for healthcare providers in late 2021. [read post]
15 Jun 2023, 9:26 pm
Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) over new measures in the Inflation Reduction Act (IRA). [read post]
14 Jun 2023, 8:02 am
Case Example -- Challenging an Administrative Exclusion Imposed by the OIG: Among its many provisions, the “Medicare-Medicaid Anti-Fraud and Abuse Amendments”[11] mandated the exclusion of physicians and other practitioners convicted of program-related crimes from participation in Medicare and Medicaid.[12] The authority to administratively exclude an individual or entity from participating in Federal health benefits programs was… [read post]
8 Jun 2023, 4:30 am
[fn3] The panel also directed that the applicant should establish his competency to manage his affairs and to comply with the Center for Medicare and Medicaid Services (CMS) requirements for self-administration. [read post]
6 Jun 2023, 3:13 pm
In conjunction with the Biden administration’s declaration that the COVID-19 national public health emergency ended effective May 11, 2023, the Centers for Medicare and Medicaid Services (CMS) announced it would “soon end” its mandatory vaccination requirement and that additional guidance would be forthcoming. [read post]
6 Jun 2023, 2:09 pm
Kandis represents relators in high stakes qui tam actions filed under the federal and state False Claims Acts relating to fraud on government healthcare payors such as Medicare, Medicaid, Department of Defense TRICARE, State Children’s Health Insurance Program, Veterans Health Administration, and the Indian Health Service program. [read post]
29 May 2023, 10:00 am
Medicare Advantage Plans are Aggressively Denying Claims – Administrative Appeals are Growing (May 25, 2023): According to the latest data released by the Centers for Medicare and Medicaid Services (CMS), beneficiaries participating in Medicare Advantage[1] plans now surpass those enrolled in original Medicare plans. [read post]
22 May 2023, 5:00 am
The Centers for Medicare & Medicaid Services (CMS) recently announced that it is planning to launch a new iteration of PECOS in Summer 2023. [read post]
11 May 2023, 2:09 pm
In addition to ending the travel restrictions, the Biden Administration also announced that the COVID-19 vaccination requirements for federal employees and federal contractors will end May 11, and the Administration will start the process to end the vaccination requirement for head start educators and CMS (Centers for Medicare and Medicaid Services)-certified facilities. [read post]
11 May 2023, 10:52 am
On November 4, 2021, the Biden administration and the Centers for Medicare and Medicaid Services (CMS) at the Department of Health and Human Services (HHS) issued an interim final rule which required certain workers at CMS-covered healthcare facilities to be vaccinated. [read post]
11 May 2023, 9:01 am
On the federal level, the Centers for Medicare and Medicaid Services (CMS) oversees nursing homes participating in the Medicare and Medicaid programs. [read post]
8 May 2023, 12:28 am
Medicare Exclusion Risks: Employing Excluded Individuals Can Result in Significant Administrative, Civil and / or Criminal Liabilities (May 8, 2023): One of the most severe administrative sanctions available under the Social Security Act stems from the authority of the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS)[1] to “exclude” individuals and entities from participating in… [read post]
3 May 2023, 7:18 am
COVID-19 vaccination requirements for federal contractors and employees, Centers for Medicare and Medicaid (“CMS”) certified health care and other providers, Head Start educators and international travelers implemented in 2021 in response to the COVID-19 health care emergency. [read post]
3 May 2023, 7:03 am
Medicare could have saved $128 million if the Centers for Medicare and Medicaid Services had the correct controls in place to avoid duplicate payments with the Veterans Health Administration, an audit by the Office of Inspector General found. [read post]
2 May 2023, 12:43 pm
The US Centers for Medicare & Medicaid Services (CMS) website provides a comprehensive Coronavirus Disease 2019 page with information on CMS Waivers, Flexibilities and the Transition Forward, including provider-specific fact sheets on Coronavirus Waivers and Administrative Flexibilities that detail “which waivers and flexibilities have already been terminated, have been made permanent, or will end at the end of the PHE. [read post]
1 May 2023, 12:27 pm
For example, EBSA assisted HHS’ Centers for Medicare and Medicaid Services in investigating an improper appeals process following the denial of coverage for autism treatment by a plan for a large school district. [read post]
