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23 Jul 2013, 11:59 am
The Centers for Medicare & Medicaid Services (CMS) is issuing demand letters seeking recoupment of reimbursement from medical providers and suppliers for Medicare beneficiaries that, according to data from the Social Security Administration (SSA), were allegedly "incarcerated" at the time services were provided. [read post]
20 May 2015, 10:23 am
CMS is hosting a Special Open Door Forum call on May 27, 2015 to discuss eliminating the Certificate of Medical Necessity (CMN) and Durable Medical Equipment (DME) Information (DIF) forms. [read post]
12 Jan 2010, 6:00 am
CMS has been increasing its effort to recover money paid erroneously to injured workers’ whose medical benefits should have been paid by their employers or workers’ compensation insurance carriers. [read post]
15 Nov 2016, 12:54 pm
CMS has announced a February 14, 2017 town hall meeting to discuss FY 2018 applications for add-on payments for new medical services and technologies under the Medicare hospital inpatient prospective payment system (IPPS). [read post]
11 Feb 2014, 4:44 pm
CMS is also considering including additional information such as Board Certification and other medical qualifications. [read post]
28 Apr 2014, 9:02 am
Next year, CMS also expects to post data regarding the measures “Patients Discharged on Multiple Antipsychotic Medications” and “Patients Discharged on Multiple Antipsychotic Medications with Appropriate Justification. [read post]
18 Nov 2014, 9:04 am
On December 9, 2014, CMS is hosting a call to provide an update on the CMS National Partnership to Improve Dementia Care in Nursing Homes. [read post]
5 Nov 2014, 11:58 am
CMS confirmed that the medical records should include the visit note from the face-to-face encounter. [read post]
4 Sep 2020, 12:30 pm
Under the proposed MCIT pathway, CMS would provide national coverage for breakthrough medical devices for on-label uses beginning on the date of FDA market authorization. [read post]
14 Jan 2022, 2:25 pm
CMS’ Three Guidance Letters on Implementation 1. [read post]
14 Aug 2023, 10:00 am
A wide range of Medicare Part-B providers and suppliers are eligible to participate, with the exception of durable medical equipment and laboratory suppliers. [read post]
18 Feb 2022, 4:36 pm
This blog post outlines CMS’s current stance on whether remote workers and executives are required to be vaccinated if the practice falls under CMS’s vaccine mandate. [read post]
12 Mar 2013, 12:25 pm
These sections related to notifications/verifications of certification and renewal of certification of CRNAs and AAs by and between CMS, employers of CRNAs/AAs, and carriers. [read post]
26 Feb 2016, 1:40 pm
Furthermore, CMS is proposing additional steps to address opioid abuse, including requirements related to point-of-sale edits to prevent opioid overutilization and access to medication-assisted treatment. [read post]
31 Jan 2019, 1:44 pm
” CMS has not provided further detail about exactly what types of incentives and rewards may be offered or their permitted dollar value, but notes that they may incentivize enrollees’ participation in disease or medication therapy management programs, receipt of preventive services such as vaccines, or engagement to understand clinically-equivalent alternative medications that may be more cost-accessible. [read post]
14 Jan 2022, 10:12 am
On November 1, 2021, the Centers for Medicare & Medicaid Services issued the “CMS Vaccine Mandate” which requires in part: vaccination of all employees of health care providers that participate in the Medicare and Medicaid programs, regardless of responsibility or patient contact, unless the employee is granted a medical or religious exemption; and development of policies and procedures related to the same. [read post]
10 Jun 2016, 2:52 pm
CMS hopes that pre-claim reviews will cut down on incorrect payments, not only caused by fraud, but also due to more prevalent causes such as insufficient documentation to support the medical necessity of the services, which is cited by CMS as the largest cause of erroneous funding. [read post]
10 Jun 2016, 2:52 pm
CMS hopes that pre-claim reviews will cut down on incorrect payments, not only caused by fraud, but also due to more prevalent causes such as insufficient documentation to support the medical necessity of the services, which is cited by CMS as the largest cause of erroneous funding. [read post]
31 Oct 2013, 10:30 am
Lastly, on September 10, 2013, CMS reached a settlement with an acute care hospital located in North Carolina which disclosed Stark law violations due to the following three arrangements: (1) its arrangement with a physician to provide medical director services; (2) its arrangement with a physician group to provide medical coding and consulting services; and (3) its arrangement with a physician and a physician group practice for the lease of office space, as none of the… [read post]
19 Jun 2009, 9:31 am
During the RAC demonstration program, many hospitals experienced claim denials where the RAC denied an inpatient hospital service as not medically necessary, but the RAC found that outpatient observation services would have been medically necessary for the patient. [read post]
