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22 May 2019, 9:00 am
If the medical practice changes ownership, then Medicare, Medicaid, and other payors will need to be properly notified of the change. [read post]
21 May 2019, 4:58 pm
Prosecutors will often claim in these type of cases that the elderly on Medicare are being short-changed on care which can be used to persuade the jury that these are serious offenses even where quality of care is not an issue.In addition to imprisonment, the Court ordered both defendants to pay a total of $1,054,839 in restitution to the Centers for Medicare and Medicaid Services. [read post]
21 May 2019, 10:00 am
You have received that dreaded letter from the Zone Program Integrity Contractor (ZPIC) for Medicare advising you that it is auditing you for the Centers for Medicare and Medicaid Services (CMS). [read post]
20 May 2019, 9:00 pm
The Centers for Medicare and Medicaid Services (CMS) issued proposed regulations in February targeting manufacturer arrangements with pharmacy benefit managers (PBMs). [read post]
20 May 2019, 7:15 am
It is important that all interested medical providers, private insurance carriers, and government agencies such as Medicare or Medicaid be made aware of their potential right of recovery. [read post]
19 May 2019, 2:30 pm
In parallel with the Department’s criminal actions, the Center for Medicare Services, Center for Program Integrity (CMS/CPI) simultaneously took adverse administrative action against 130 DME companies that had submitted over $1.7 billion in claims and were paid over $900 million. [read post]
17 May 2019, 6:17 am
The hospitals — Christus Santa Rosa Medical Center, Southwest General Hospital, University Hospital — ranked in the federal government’s bottom 25 percent of medical centers this year, along with 800 others nationally, in an annual survey by the Centers for Medicare and Medicaid Services (CMS). [read post]
15 May 2019, 1:38 pm
The MDPCP is one component of the Maryland Total Cost of Care Model, which is an agreement between the State of Maryland and the Centers for Medicare and Medicaid Services (CMS). [read post]
15 May 2019, 1:00 pm
Medications prescribed for the injured worker are expected to be included in the MSA to gain approval by the Centers for Medicare and Medicaid Services. [read post]
12 May 2019, 9:05 pm
” In November 2018, the Centers for Medicare and Medicaid Services (CMS) proposed changes to its regulations under Medicare Advantage—also known as Medicare Part C—and the Medicare Part D Prescription Drug Benefit program. [read post]
11 May 2019, 6:22 am
The Centers for Medicare & Medicaid Services is launching this app as part of their “eMedicare” initiative designed to strengthen Medicare and help those covered by the program make better health decisions by making information clearer and more easily accessible online. [read post]
10 May 2019, 1:25 pm
The Centers for Medicare & Medicaid Services (CMS) released a draft guidance for state survey agencies on May 3, 2019, impacting hospitals that share space, staff, and/or services with another co-located hospital or health care entity. [read post]
10 May 2019, 8:16 am
In order to secure a new Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) contractor, the Centers for Medicare and Medicaid Services (CMS) has temporarily paused both Short Stay and Higher Weighted Diagnosis-Related Group (HWDRG) reviews. [read post]
9 May 2019, 2:35 pm
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule streamlining the process for Medicare Parts A and B claims appeals and for Medicare Part D coverage determination appeals in order to “reduce associated burden on providers, beneficiaries, and appeals adjudicators. [read post]
9 May 2019, 8:29 am
The Centers for Medicare & Medicaid Services (CMS) is revoking the authority of states to “divert” certain Medicaid provider payments to a third party (rather than make the payment directly to the provider) to fund other costs on behalf of the provider “for benefits such as health insurance, skills training, and other benefits customary for employees. [read post]
9 May 2019, 8:06 am
On Wednesday, May 8, 2019, Health and Human Services(“HHS”) Secretary Alex Azar announced the adoption of a Medicare and Medicaid Programs; Regulation to Require Drug Pricing Transparency Final Rule (the “Rule”) by the Centers for Medicare & Medicaid Services (“CMS”) requiring direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or… [read post]
8 May 2019, 2:12 pm
Medical equipment suppliers can submit bids for Round 2021 of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP) from July 16 through September 18, 2019, the Centers for Medicare & Medicaid Services (CMS) has just announced. [read post]
8 May 2019, 12:44 pm
She regularly helps employer and other health benefit plan sponsors and vendors, health industry, insurers, health IT, life sciences and other health and insurance industry clients design, document and enforce plans, practices, policies, systems and solutions; manage regulatory, contractual and other legal and operational compliance; vendors and suppliers; deal with Medicare, Medicaid, CHIP, Medicare/Medicaid Advantage, ERISA, state insurance law and other private… [read post]
7 May 2019, 9:05 pm
Seema Verma, the current Administrator for the Centers for Medicare and Medicaid Services (CMS), has argued that the growth in Medicaid enrollment is not a cause for celebration, and that “for able bodied adults, we should celebrate helping people move up, move on, and move out” of the Medicaid program. [read post]
6 May 2019, 6:30 pm
"In its update in April to Nursing Home Compare, the Centers for Medicare & Medicaid Services gave its lowest star rating for staffing — one star... [read post]
