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30 Jan 2023, 11:11 pm by Michael Rosenblat
On January 18, 2023, CMS issued a press release announcing a new action to reduce what CMS termed the improper diagnosis of schizophrenia and the inappropriate use of antipsychotic medications. [read post]
21 Jun 2012, 3:02 am by Jon L. Gelman
The Centers for Medicare and Medicaid Services (CMS) is proposing several options to efficiently and effectively handle issues concerning the payment of future medicals. [read post]
15 Oct 2018, 8:00 am by Jerri Lynn Ward, J.D.
The post CMS Moves to Make Approval of Medical Devices More Efficient appeared first on Garlo Ward, P.C.. [read post]
5 Aug 2021, 5:24 am by Wachler & Associates, P.C.
CMS recently announced in June 2021 that MACs are authorized to begin conducting post-payment medical reviews for dates of service during and after March 2020. [read post]
26 Nov 2012, 7:35 am
CMS contractors are required to deny a provider's claim for repayment if the item or service is not reasonable and medically necessary. [read post]
26 Oct 2016, 1:04 pm by Debra A. McCurdy and Yetunde Oni
  The parallel review initiative allows concurrent FDA and CMS review of a medical device with the goal of reducing the time between FDA marketing approval or granting of a de novo request and Medicare coverage decisions, thereby “facilitating earlier access to innovative medical technologies for Medicare beneficiaries. [read post]
5 May 2010, 9:47 am
CMS recently issued Transmittal 327, which sets forth new and tougher signature requirements for medical records. [read post]
5 May 2010, 9:47 am
CMS recently issued Transmittal 327, which sets forth new and tougher signature requirements for medical records. [read post]
7 Dec 2011, 3:37 pm
The Centers for Medicare & Medicaid Services (CMS) issued its final medical loss ratio (MLR) rule on December 2. [read post]
7 Dec 2011, 3:37 pm
The Centers for Medicare & Medicaid Services (CMS) issued its final medical loss ratio (MLR) rule on December 2. [read post]
15 Nov 2016, 1:02 pm by Debra A. McCurdy
Under this program, CMS will direct Medicare Administrative Contractors (MACs), Recovery Audit Contractors (RACs), and the Supplemental Medical Review Contractor to make claims submitted by certain Advanced APMs providers a “low priority for medical record reviews. [read post]
4 Oct 2015, 9:11 am by Debra A. McCurdy
The latest CMS “innovation model” will test whether providing Medicare Part D prescription drug plan (PDP) sponsors with financial incentives and flexibility with regard to medication therapy management (MTM) program requirements can improve quality and reduce costs by “right-sizing” investment in MTM services. [read post]
17 Jan 2020, 12:20 pm by Debra A. McCurdy
The Centers for Medicare & Medicaid Services (CMS) has released a Request for Information (RFI) on how the Medicaid program can incorporate out-of-state providers in coordinating care for children with certain medically complex conditions under Medicaid. [read post]
29 Feb 2016, 7:08 am by Debra A. McCurdy
CMS notes that the number of units/hours of therapy provided in a day is of “particular interest” during the medical review process. [read post]
29 Sep 2011, 4:40 am by Vanessa Kurzweil
  CMS has told hospitals receiving federal funding they must accept as a patient's medical representative any person the patient names or has named in an advance directive. [read post]
24 Sep 2021, 3:44 pm by luiza
CMS suspended three UnitedHealth Medicare Advantage (MA) plans and one Anthem MA plan this week for failing to meet federal Medical Loss Ratio requirements. [read post]
13 Jan 2014, 8:44 am
Specifically, the report revealed whether or not the surveyors found any changes in the practices of nursing home facilities after CMS launched its antipsychotic medication initiative. [read post]
13 Oct 2015, 11:54 am by Debra A. McCurdy
CMS has announced that it will not adopt changes to miscellaneous durable medical equipment (DME) HCPCS codes on January 1, 2016, as it had proposed earlier this year in order to promote more accurate payment of DME claims. [read post]
5 Oct 2016, 1:50 pm by Lisa Baird
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]
6 Feb 2024, 12:28 pm by Julia Kourpas
Dora Hughes, MD, acting CMS chief medical officer and acting director of the Center for Clinical Standards and Quality shared that “the team received more than 46,000 comments on the proposal, which are being used to inform the development of the final rule, which we intend to finalize this year. [read post]