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8 Aug 2012, 10:53 am
Last week, after our ongoing communication with Centers for Medicare & Medicaid Services (CMS) and a Medicare Administrative Contractor, we obtained a CMS memorandum which provides a very specific avenue for hospitals to obtain full Part B reimbursement in the event that an inpatient claim is denied as not being medically necessary and reasonable and the ALJ issues an order for outpatient observation services. [read post]
8 Aug 2012, 10:32 am
Last week, after our ongoing communication with Centers for Medicare & Medicaid Services (CMS) and a Medicare Administrative Contractor, we obtained a CMS memorandum which provides a very specific avenue for hospitals to obtain full Part B reimbursement in the event that an inpatient claim is denied as not being medically necessary and reasonable and the ALJ issues an order for outpatient observation services. [read post]
8 Aug 2012, 10:16 am
The following organizations and government agencies are among the first to join the partnership: America’s Health Insurance Plans Amerigroup Corporation Blue Cross and Blue Shield Association Blue Cross and Blue Shield of Louisiana Centers for Medicare & Medicaid Services Coalition Against Insurance Fraud Federal Bureau of Investigations Health and Human Services Office of Inspector General Humana Inc. [read post]
3 Aug 2012, 7:52 am
., Board Certified by The Florida Bar in Health LawOn July 31, 2012, the Centers for Medicare and Medicaid Services (CMS) announced on its website that hospitals should brace themselves for prepayment audits beginning August 27, 2012.The CMS originally announced the Recovery Audit Prepayment Review (RAPR) Demonstration Project in November of 2011 for a January 1, 2012 start date, then delayed it to June 1, 2012, then again to, “summer of 2012. [read post]
2 Aug 2012, 9:19 am
That “fundamental” change was worked seventy-five years before by the Social Security Act and fifty years before with Medicare. [read post]
31 Jul 2012, 9:11 am
He said that if you look at the Medicaid provisions, both Colorado and Nevada will likely take the expanded Medicaid, though Nevada is not 100% sure. [read post]
31 Jul 2012, 9:11 am
He said that if you look at the Medicaid provisions, both Colorado and Nevada will likely take the expanded Medicaid, though Nevada is not 100% sure. [read post]
30 Jul 2012, 9:29 am
Presumably, this will involve the extension of the use of state-of-the-art technology and data mining practices like those the Centers for Medicare & Medicaid Services (CMS) already uses to review claims, to track suspected fraud trends and flag suspected fraudulent activity. [read post]
30 Jul 2012, 7:49 am
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. [read post]
30 Jul 2012, 7:49 am
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. [read post]
30 Jul 2012, 7:49 am
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. [read post]
30 Jul 2012, 7:49 am
On May 16, 2012, the Centers for Medicare and Medicaid Services of the Department of Health and Human Services (“CMS”) published regulations announcing various changes to the Medicare Conditions of Participation (“CoP”) applicable to hospitals. [read post]
27 Jul 2012, 11:15 am
The following organizations and government agencies are among the first to join this partnership: America's Health Insurance Plans Amerigroup Corporation Blue Cross and Blue Shield Association Blue Cross and Blue Shield of Louisiana Centers for Medicare & Medicaid Services Coalition Against Insurance Fraud Federal Bureau of Investigations Health and Human Services Office of Inspector General Humana Inc. [read post]
26 Jul 2012, 1:39 pm
The Center for Medicare and Medicaid Services (CMS) made long awaited updates to the Medicare Medicaid SCHIP Extension Act (MMSEA) User Guide for Non-Group Health Plans (NGHP). [read post]
26 Jul 2012, 11:32 am
Almost 40 percent of nursing-home residents with dementia received the drugs in 2010, according to the Center for Medicare and Medicaid Services. [read post]
25 Jul 2012, 1:21 pm
January 1, 2013 is the final date for CMS approval for the state exchange plans (as an aside, Lynn said that the Center for Consumer Information and Insurance Oversight, which she calls the new federal department of health insurance, is housed within the Centers for Medicare and Medicaid Services, and this January 1 date is when they must approve it). [read post]
24 Jul 2012, 8:38 am
The federal Medicaid law sets a 180-day deadline for filing such an appeal with the Provider Reimbursement Review Board, an entity within the Department of Health & Human Services, which runs Medicare. [read post]
20 Jul 2012, 8:15 pm
Under the intended process announced by HHS Center for Consumer Information and Insurance Oversight (CCIIO) on December 16, 2011, HHS announced that it would allow each state to decide the EHBs package on a state-by-state by choosing a “benchmark health plan” that meets HHS standards. [read post]
16 Jul 2012, 6:06 pm
The National Health Expenditure Accounts (NHEA), published by the Centers for Medicare and Medicaid Services (CMS), are the official estimates of total national healthcare spending. [read post]
11 Jul 2012, 1:48 pm
The Centers for Medicare & Medicaid Services (CMS) released the proposed rules and the public is free to comment on the changes throughout a 60-day period that ends September 4, 2012. [read post]
