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21 Jun 2012, 3:02 am
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]
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]
5 Aug 2021, 5:24 am
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]
17 Jan 2020, 12:20 pm
The RFI is intended to help CMS implement a provision of the Medicaid Services Investment and Accountability Act of 2019 that gives states the option to cover Medicaid health home services for children with medically complex conditions who choose to enroll in a health home. [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]
26 Oct 2016, 1:04 pm
The Food and Drug Administration (FDA) and the Centers for Medicare & Medicaid Services (CMS) have announced that they are making permanent their “Program for Parallel Review of Medical Devices,” which is now operating as a pilot program. [read post]
7 Aug 2013, 8:06 am
On August 2, 2013, the Centers for Medicare & Medicaid Services ("CMS") released its much-anticipated final rules, CMS-1455-F and CMS-1599-F, finalizing two previously issued proposals that addressed payment policies related to patient status in short-stay hospital cases: (1) payment of Medicare Part B inpatient services; and (2) admission and medical review criteria for payment of hospital inpatient services under Medicare Part A. [read post]
2 Nov 2023, 9:00 am
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) quietly added “Outreach Site/ Street” as an allowable place of service (POS) code for Medicare and Medicaid providers to use in claims submission for “street medicine” services provided. [read post]
4 Oct 2015, 9:11 am
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]
29 Feb 2016, 7:08 am
CMS has released information about its plans for implementing Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) provisions regarding the manual medical review process for outpatient therapy services over the annual threshold. [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]
21 Feb 2019, 4:22 am
The Centers for Medicare & Medicaid Services (CMS) plans to test a new voluntary emergency ambulance service innovation model that seeks promote “the most appropriate level of care at the right time and place. [read post]
29 Sep 2011, 4:40 am
Hospitals that receive Medicare or Medicaid funding must generally allow a same-sex domestic partner to be a medical representative for an incapacitated patient, according to guidance issued this month by the Centers for Medicare and Medicaid Services (CMS) within the U.S. [read post]
1 Feb 2024, 9:00 am
CMS’s New Actions Related to EMTALA On January 22, 2024, the Department of Health and Human Services (HHS) announced that, through the Centers for Medicare & Medicaid Services (CMS), it will launch a comprehensive plan related to the Emergency Medical Treatment and Labor Act (EMTALA). [read post]
22 Jul 2019, 10:34 am
On Tuesday July 16, 2019 the Centers for Medicare and Medication Services (CMS)announced its proposal to delay implementation of certain portions of its third phase of requirements for long term care facilities. [read post]
8 Feb 2016, 7:35 am
CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [read post]
8 Feb 2016, 7:35 am
CMS explains that it is aligning the timing and scope of the Medicaid medical equipment face-to-face encounter requirements with the parallel rules for Medicare durable medical equipment (DME). [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]
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]
