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15 Jun 2018, 9:38 am
Settlement Conference Facilitation (SCF) is an alternative dispute resolution process which provides appellants and the Center for Medicare and Medicaid Services (CMS) an opportunity to discuss a mutually agreeable resolution for claims appealed to the Administrative Law Judge (ALJ) or Medicare Appeals Council (Council) levels of appeal. [read post]
30 Jul 2019, 12:17 pm
On July 29, the Centers for Medicare & Medicaid Services (CMS) published three proposed rules for Calendar Year (CY) 2020: Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule; Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule (MPFS); and End State Renal Disease (ESRD) and Durable Medical Equipment… [read post]
3 Feb 2011, 8:39 am
Berwick, administrator of the Centers for Medicare and Medicaid Services (”CMS”), indicated that a proposal outlining the Obama administration’s preferred ground rules for new accountable care organizations should be out within a month. [read post]
21 May 2014, 1:25 pm
On May 19, 2014, Centers for Medicare and Medicaid Services ("CMS") announced that it is considering new ways to define and pay for hospital short-stays. [read post]
19 Apr 2016, 9:21 am
The residential provider self-assessment is designed to enable the Texas Department of Aging and Disability Services (DADS) to evaluate the extent to which DADS regulations, standards, policies, licensing requirements, and other provider requirements comply with federal regulations issued by the Centers for Medicare & Medicaid Services (CMS). [read post]
12 Jul 2010, 2:03 am
In late June, two Members of Congress requested that the Centers for Medicare and Medicaid Services (CMS) expedite the implementation of a Medicare home care demonstration project. [read post]
17 Dec 2021, 11:08 am
As we previously reported, the Centers for Medicare & Medicaid Services’ (CMS’s) interim final rule (the “Rule”) requiring full COVID-19 vaccination for staff and others at Medicare- and Medicaid-certified providers and suppliers (i.e., the “vaccine mandate”) was effectively stayed nationwide on November 30, 2021, by the U.S. [read post]
2 Nov 2014, 1:00 am
On Friday, the Centers for Medicare and Medicaid Services (CMS) issued a final rule (PDF here) for physician reimbursement under Medicare in 2015. [read post]
30 Jun 2017, 10:23 am
On June 20, 2017, The Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule which would exempt a greater number of small practices from complying with the Medicare Access and CHIP Reauthorization Act of 2015 (“MACRA”). [read post]
9 Aug 2019, 6:00 am
On August 2, 2019, the Centers for Medicare & Medicaid Services (CMS) published its Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (PPS) final rule (CMS-1716-F). [read post]
Healthcare News from Capitol Hill and the Department of Health and Human Services - January 24, 2011
24 Jan 2011, 2:01 am
CMS ISSUES PROPOSED RULE FOR VALUE-BASED PURCHASING:On January 7, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule to establish a value-based purchasing (VBP) program to reward hospitals for providing safe, high-quality care. [read post]
29 Nov 2021, 6:05 am
In early 2020, the Centers for Medicare and Medicaid Services (CMS) directed its contractors to pause audit activities as auditors were unable to work in the office and healthcare providers were reeling from the multiple impacts of the pandemic. [read post]
8 Aug 2017, 6:30 am
While the Commercial Repayment Center (CRC) has faced some valid criticism over the course of the past year and half in relation to its recovery efforts on behalf of the Centers for Medicare and Medicaid Services’ (CMS), not all problems start with the CRC. [read post]
18 Dec 2013, 12:46 pm
On Thursday, December 19, 2013, from 1:00-2:00 pm Eastern Time, the Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to answer questions from hospitals, practitioners, and other interested parties about the new policies released on August 2, 2013 as part of the Fiscal Year (FY) 2014 Inpatient Prospective Payment System (IPPS)/Long-Term Care Hospital (LTCH) Final Rule (CMS-1599-F) and corresponding… [read post]
22 Jun 2022, 5:00 am
The Supplemental Medical Review Contractor, or SMRC, is a contractor with the Centers for Medicare & Medicaid Services (CMS) that performs a variety of Medicare and Medicaid audit and medical review tasks. [read post]
15 Dec 2011, 11:28 am
KV Pharmaceutical (KV), the parent company for Ethex Corporation (Ethex), this month agreed to pay $17 million to settle claims that Ethex of violated the False Claims Act when it allegedly reported false information to the Centers for Medicare and Medicaid Services (CMS). [read post]
20 Apr 2023, 7:59 am
In part I, we discussed whether federal district courts could exercise jurisdiction under the federal-question statute over legal challenges to overpayment determinations made by the Centers for Medicare & Medicaid Services (CMS) under the agency’s controversial Risk Adjustment Data Validation (RADV) program for Medicare Advantage (MA) organizations. [read post]
20 Nov 2019, 3:16 pm
Comments may be submitted electronically to www.regulations.gov, or by mail to: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-9915-P, P.O. [read post]
25 Jun 2013, 1:04 pm
The Centers for Medicare & Medicaid Services (CMS) contract RACs to detect and recuperate improper Medicare program payments. [read post]
24 Feb 2012, 6:30 am
Yesterday the Centers for Medicare & Medicaid Services (CMS) announced the proposed rule for Stage 2 Meaningful Use under the the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs which is a part of the Health Information Technology for Economic and Clinical Health Act (HITECH).The incentive program is part of the national health information technology reform effort under the American Recovery and Reinvestment… [read post]
