Search for: "CMS Medical"
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30 Jun 2011, 10:13 pm
CMS now views a claim as accepted despite the lack of medical payments on the payment history if the case settles for indemnity as opposed to a purchase of peace, includes past medical bills and/or reimbursement of group insurance liens and is court approved prior to CMS’ determination of the MSA. [read post]
18 Jun 2012, 5:49 am
The ANPRM sets forth seven standardized options that CMS is considering making available to beneficiaries and their representatives to clarify how they can meet their obligations to protect Medicare’s interest with respect to MSP claims for future medicals. [read post]
18 Jun 2012, 5:49 am
The ANPRM sets forth seven standardized options that CMS is considering making available to beneficiaries and their representatives to clarify how they can meet their obligations to protect Medicare’s interest with respect to MSP claims for future medicals. [read post]
19 Nov 2014, 2:34 pm
CMS is deleting the definition of “covered device” as duplicative of the definition of “covered drug, device, biological or medical supply. [read post]
14 Mar 2012, 12:10 pm
Under the RADV program, CMS will verify that diagnosis codes submitted for payment by an MA organization are supported by the enrollee’s medical record documentation. [read post]
17 Jan 2018, 5:00 am
The FFP limitation does not apply to prosthetics, orthotics, or medical supplies, nor does it apply to items for which Medicaid is not the primary payer. [read post]
27 Oct 2016, 7:57 am
CMS expects to discuss the following topics:Ongoing Responsibility for Medicals (ORM) recovery, Final Conditional Payment (CP) process reminders, Medicare Secondary Payer Recovery Portal (MSPRP) improvements.CMS staff and representatives from the Commercial Repayment Center (CRC) will participate. [read post]
14 Jan 2014, 1:57 pm
In a National Provider Call today, CMS representatives described how the agency and its contractors will review claims under the two-midnight rule.CMS stated today that the “medical review benchmark” will include the total time (excluding wait times) a patient spends getting medically necessary care in the hospital. [read post]
14 Jan 2014, 1:57 pm
In a National Provider Call today, CMS representatives described how the agency and its contractors will review claims under the two-midnight rule.CMS stated today that the “medical review benchmark” will include the total time (excluding wait times) a patient spends getting medically necessary care in the hospital. [read post]
3 May 2021, 2:13 pm
Since the start of the COVID-19 pandemic, medical providers have been forced […] The post CPT Code 99072, Introduced for COVID-19, Finalized as Bundled Service by CMS appeared first on ROIG Lawyers. [read post]
30 Sep 2016, 4:58 am
CMS will also implement a $750 threshold for no-fault insurance and workers’ compensation settlements, where the no-fault insurer or workers’ compensation entity does not otherwise have ongoing responsibly for medicals. [read post]
28 Mar 2013, 7:59 am
., co-chairs of the firm's Medicare and RAC department authored an ABA Health eSource article titled "CMS Acquiesces to Hospital Pressure, Allows Part B Billing of Hospital Services Following Part A Denial of Inpatient Hospital Claims for Medical Necessity: Is It Enough?" [read post]
6 Jun 2019, 1:18 pm
The Centers for Medicare & Medicaid Services (CMS) has instructed state survey agencies that they must conduct onsite complaint investigations related to Emergency Medical Treatment and Labor Act (EMTALA) complaints and surveys of death in restraint or seclusion in hospitals and critical access hospitals within two business days instead of five. [read post]
30 Mar 2022, 9:02 pm
At the beginning of 2022, Medicare Part B beneficiaries began paying 14.5 percent more for their monthly premiums, which cover medical services such as doctors’ services and outpatient care. [read post]
24 Jun 2015, 6:13 am
The CMS Independence at Home Demonstration saved more than $25 million during its first performance year while delivering high-quality patient care, according to a June 18, 2015 CMS announcement. [read post]
24 Jun 2015, 6:13 am
The CMS Independence at Home Demonstration saved more than $25 million during its first performance year while delivering high-quality patient care, according to a June 18, 2015 CMS announcement. [read post]
18 Jan 2017, 7:06 am
A WCMSA, as CMS states, is a “financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury. [read post]
7 Dec 2018, 8:44 am
” We would note, however, that these modifications to the application process do not address broader concerns that CMS’s standard for new codes is too rigid, particularly for medical devices, which results in insufficiently-granular codes and imposes a barrier to adoption of new medical technologies. [read post]
27 Jun 2018, 11:33 am
Will the new CMS initiatives help curb fraud and waste in Medicaid? [read post]
19 Apr 2018, 7:09 am
As announced, CMS’s short-term efforts in connection with the MyHealthEData initiative include: Launching Medicare’s Blue Button 2.0, which will allow a patient to access and share his/her healthcare information and medical history with a new physician, leading to less duplication in testing and enabling continuity of care. [read post]
