Search for: "CMS MEDICARE CLAIMS OFFICE"
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17 Jul 2018, 6:30 am
One way to prevent CMS from pursuing a future action for recovery after a claim is settled is by setting up a Medicare Set-Aside (“MSA”) to cover the costs of future medical treatment for the allowed conditions in the settled claim and submitting the MSA proposal to CMS for review. [read post]
19 Jan 2021, 8:43 pm
Today, prepayment audits of Medicare claims are now conducted by MACs and other CMS contractors around the country. [read post]
27 Oct 2017, 12:41 pm
A recent Office of Inspector General (OIG) report suggests that the lack of medical device-specific information on Medicare claim forms complicates CMS efforts to identify and track Medicare costs related to the replacement of recalled or prematurely failed medical devices. [read post]
23 Jun 2008, 7:48 am
Medicare set-asides and the new CMS rules regarding the liability side of the house will take effect in July 2009. [read post]
2 Apr 2018, 12:02 pm
A recent report by the Government Accountability Office (GAO) claims state and federal agencies tasked with evaluating experimental programs from the Centers for Medicare and Medicaid Studies (CMS) fail to properly evaluate the initiatives. [read post]
5 Oct 2016, 1:50 pm
On September 30, 2016, the Department of Health and Human Service’s Office of the Inspector General (OIG) issued an “Early Alert” to the Centers for Medicare & Medicaid Services (CMS) on “Incorporating Medical Device-Specific Information on Claim Forms”. [read post]
1 Mar 2023, 9:29 am
This applies to both CMS RADV audits as well as Department of Health and Human Services Office of Inspector General (“OIG”) RADV audits. [read post]
15 Aug 2019, 1:57 pm
The Centers for Medicare & Medicaid Services (CMS) has published its proposed Medicare physician fee schedule (PFS) rule for calendar year (CY) 2020. [read post]
19 Jul 2016, 8:42 am
According to the proposed rule, the requirement that ordering professionals begin consulting CDSMs and furnishing professionals append AUC-related information to the Medicare claim will not begin earlier than January 1, 2018. [read post]
16 Feb 2016, 12:15 pm
The suit claims that CMS regularly communicates information to blind persons using inaccessible electronic formats and print. [read post]
14 Jul 2014, 1:23 pm
The settlement conference facilitator, an employee of the Office of Medicare Hearings and Appeals ("OMHA"), will oversee the process. [read post]
26 Jun 2017, 8:09 am
Physicians currently use a SSN-based Health Insurance Claim Number (“HICN”) for Medicare transactions like billing, eligibility status, and claim status. [read post]
29 May 2023, 10:00 am
Medicare Advantage Plans are Aggressively Denying Claims – Administrative Appeals are Growing (May 25, 2023): According to the latest data released by the Centers for Medicare and Medicaid Services (CMS), beneficiaries participating in Medicare Advantage[1] plans now surpass those enrolled in original Medicare plans. [read post]
19 Mar 2012, 3:33 pm
Specifically, in its alert the OIG officials state that “physicians who reassign their right to bill the Medicare program and receive Medicare payments by executing the CMS-855R application may be liable for false claims submitted by entities to which they reassigned their Medicare benefits. [read post]
12 Jun 2017, 4:29 pm
The call will also cover how certain appeals pending at the Office of Medicare Hearings and Appeals “may be eligible for more efficient adjudication through statistical sampling. [read post]
7 Aug 2013, 8:06 am
Payment of Medicare Part B Inpatient Services First, CMS finalized its March 13, 2013 Proposed Rule CMS-1455-P. [read post]
23 Jul 2013, 11:59 am
CMS Regional Office contact information may be found here. [read post]
24 Oct 2019, 2:36 pm
In a blog post accompanying the release of the RFI, CMS Administrator Seema Verma referenced the Government Accountability Office’s designation of “Medicare as a High Risk program since 1990 because of its size, complexity and susceptibility to improper payments. [read post]
23 Jul 2018, 5:16 am
However, CMS will pay claims for ADI services in 2020 regardless of whether the claims report the AUC consultation. [read post]
9 Feb 2024, 12:32 pm
False Claims Act Judgments: CMS could revoke or deny enrollment if a provider or supplier had a civil judgment imposed against them within the previous 10 years. [read post]
