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9 Jan 2014, 10:02 am
Claims of liens by Medicare (Centers for Medicare and Medicaid Services (CMS) and/or the Medicare Secondary Payer Recovery Contractor (MSPRC)), Medicare Part C providers (Medicare Advantage Plans), Departments of Social Services, and subrogation recovery contractors for ERISA governed plans and policies are perhaps the most misunderstood and confusing aspects of the case resolution process. [read post]
2 Jul 2013, 12:08 pm
The Department of Health & Human Services (HHS) Office of Inspector General (OIG) is recommending that the Centers for Medicare & Medicaid Services (CMS) step-up efforts to collect Medicare overpayments to providers currently considered uncollectable because the provider has failed to repay overpayments identified and demanded by CMS six or more months after CMS demands repayment. [read post]
1 Nov 2018, 9:57 am
Nursing home facilities in Georgia, and around the country, are evaluated on a routine basis by the Centers for Medicare and Medicaid Services (CMS), as well as state agencies that regulate nursing homes. [read post]
21 Jan 2021, 6:19 am
On January 15, 2021, the Centers for Medicare & Medicaid Services (CMS) finalized the agency’s “CMS Interoperability and Prior Authorization” rule to improve the prior authorization process and give patients more control in accessing and understanding their health data. [read post]
19 Nov 2010, 5:08 am
The Centers for Medicare and Medicaid Services (CMS) has filed a Motion to Amend its complaint in a lawsuit that will define the Statute of Limitations in a Medicare Secondary Payer (MSP) recovery action. [read post]
21 Jun 2012, 3:55 pm
This week, The American Medical Directors Association (AMDA), issued a letter (Click for Article) to nursing home medical directors asking them to join with Centers for Medicare & Medicaid Services (CMS) in their national initiative to reduce the use of unnecessary and potentially dangerous drugs in nursing homes. [read post]
2 Oct 2019, 11:25 am
The most common causes of a Medicare or Medicaid fraud investigation are: Phantom billing – billing for services that were never performed Submitting a claim for unnecessary medical services or medical equipment Submitting a claim for medical supplies, equipment, or services that were never ordered Submitting a claim of certification for medically unnecessary supplies Submitting a claim of certification for medically unnecessary… [read post]
6 Apr 2011, 8:11 pm
In December, the Centers for Medicare and Medicaid Services delayed implementation until April because of complaints from providers, who claimed that the rule was too stringent and most doctors were unaware of the change. [read post]
11 Nov 2011, 8:51 am
On July 19, 2011, the Centers for Medicare and Medicaid Services ("CMS") published in the Federal Register its CY 2012 Physician Fee Schedule Proposed Rule ("Proposed Rule"). [read post]
1 May 2013, 11:43 am
On April 26, 2013, the Centers for Medicare & Medicaid Services (“CMS”) released the proposed update to the Medicare long-term acute care hospital prospective payment system (“LTCH PPS”) policies and payment rates for fiscal year (“FY”) 2014. [read post]
OIG Testimony Before Congressional Subcommittee Outlines Inadequacies of Medicaid Integrity Programs
19 Jun 2012, 7:47 am
The testimony focused on two national Medicaid integrity programs: the Centers for Medicare and Medicaid Services' (CMS) National Medicaid Audit Program, and the Medicare-Medicaid Data Match Program (Medi-Medi). [read post]
19 Nov 2020, 8:08 pm
Though Medicare requires direct supervision over these cardiology services, the company billed the government for services under the owner, Dr. [read post]
28 Jul 2016, 9:00 am
On July 6, 2016, the Centers for Medicare & Medicaid Services ("CMS") released the 2017 Outpatient Prospective Payment System ("OPPS") Proposed Rule (the "Proposed Rule"). [read post]
10 Nov 2009, 6:37 am
On November 10, 2009, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare Home Health Prospective Payment rates for the 2010 calendar year (the "Final Rule"). [read post]
10 Apr 2014, 1:33 am
In what it called an effort to increase transparency on government spending on health care, the Centers for Medicaid and Medicare Services released for the first-time a breakdown on Medicare spending by physician. [read post]
20 Dec 2007, 11:21 am
Keenan of The Connecticut Elder Law Blog posted this story pointing to a list of the worst nursing homes in the US by the federal government’s Center for Medicare and Medicaid Services (CMS). [read post]
10 Jun 2009, 6:00 am
Further to my entry of May 22, the Centers for Medicare & Medicaid Services ("CMS") has now made available its application to request a review of a denial of the new COBRA subsidy. [read post]
5 Aug 2020, 10:55 am
On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (CMS) issued the CY 2021 Physician Fee Schedule (PFS) proposed rule. [read post]
9 Jan 2018, 12:27 pm
Rubidoux To ensure the public remains fully informed, the Centers for Medicare and Medicaid Services (CMS) and the state of California conduct routine unannounced visits, inspections, and surveys of every nursing home statewide. [read post]
19 Mar 2020, 8:02 am
Beginning on March 6, 2020, the Centers for Medicare and Medicaid Services (“CMS”) has temporarily expanded telehealth services for Medicare beneficiaries and cut back on HIPAA enforcement to help combat the COVID-19. [read post]
