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5 Oct 2021, 6:09 am
This concern stems from the current guidelines for clinical trials for medical devices. [read post]
13 Oct 2015, 6:57 am
In a continuation of the Administration’s efforts to make Medicare spending data more transparent, CMS has released detailed payment information regarding physicians and other providers who order durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) for Medicare beneficiaries. [read post]
CMS Provides Sneak Preview of Future DMEPOS Competitive Bidding Plans Before Retracting Announcement
13 Feb 2017, 5:00 am
One week after unveiling the next round of Medicare durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) competitive bidding, the Centers for Medicare & Medicaid Services (CMS) has announced a “temporary delay” in order “to allow the new administration further opportunity to review the program. [read post]
9 Nov 2007, 2:57 pm
Update 11/11/07: From the horse's mouth (CMS release):On November 9, 2007, a final rule delaying the effective date of certain provisions of Phase III (CMS-1810-F) was made available for Public Inspection at the Office of the Federal Register. [read post]
30 May 2012, 6:56 am
The Sunshine Act was devised to prevent conflicts of interest between physicians and the medical device/pharmaceutical industries, and to ensure transparency for patients. [read post]
8 Jan 2018, 1:04 pm
Based upon the Tower MSA CMS Reconciliation Module, which reviews all MSA determinations for the purpose of identifying trends in CMS WCMSA allocation practices, CMS consistently disregards any active weaning or tapering process or scheduled reduction to future medication use and instead takes the latest dosage found in the medical records and/or prescription history and extrapolates it over the claimant’s life expectancy. [read post]
23 Feb 2024, 5:00 am
CMS emphasized that this included that MAOs make medical necessity determinations based on the circumstances of each specific individual including the patient’s medical history, physician recommendations, and clinical notes; and in line with all fully established Traditional Medicare coverage criteria (including established criteria in applicable Medicare statutes, regulations, National Coverage Determinations (NCDs), or Local Coverage Determinations (LCDs)), or with… [read post]
15 Mar 2013, 9:27 am
In many cases, hospitals have argued that the inpatient services were medically necessary. [read post]
20 Feb 2015, 6:20 am
In a statement following CMS's announcement, the President of the American Medical Association ("AMA"), Steven J. [read post]
20 Jun 2016, 3:05 am
CMS also has announced that beginning June 6, 2016, BFCC-QIOs must re-review all short stay patient status claims that were denied under the QIO medical review process. [read post]
1 Jun 2016, 8:27 am
CMS recently released the names of the new contract suppliers under the Round 2 Recompete of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program and the national mail-order competition for diabetes supplies. The CMS announcement was followed shortly by release of an HHS Office of Inspector General (OIG) report that flags problems with the state licensure status of some contract suppliers currently… [read post]
8 Apr 2014, 10:10 am
The data CMS plans to collect for each patient includes: • Pain, • Respiratory status, • Medications, • Patient preferences, and • Beliefs and values. [read post]
5 Apr 2017, 6:30 am
In response to this announcement, you would be correct in asking, how can CMS deny payment for medical care based upon an LMSA an NFMSA process that does not yet exist? [read post]
27 Apr 2009, 7:35 am
The Centers for Medicare and Medicaid Services ("CMS") recently published a final rule addressing termination of non-random prepayment complex medical review, which became effective January 1, 2009. [read post]
28 Jun 2010, 11:17 am
CMS has released the proposed physician fee schedule and other Medicare Part B payment policies to ensure their payment systems reflect the changes in medical practice and relative value services. [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]
21 Feb 2013, 3:58 am
February 12, 2013 Effective immediately, if a WCMSA proposal amount was originally submitted via the web-portal, a re-evaluation of an approved WCMSA amount can be requested through the WCMSA web portal, if the claimant or submitter believes that a CMS determination: • contains obvious mistakes, such as mathematical errors or a failure to recognize that medical records already submitted show a surgery CMS priced has already occurred, or• misinterpreted… [read post]
8 Jun 2011, 8:08 am
According to other sources, however, the first Stark case involved Saints Medical Center in Lowell, Massachusetts, and the alleged violations related to night coverage, medical directorships, and stipends. [read post]
28 Feb 2018, 7:18 am
CMS has set the dates for its annual meetings to discuss applications for new and revised HCPCS codes: May 14-17, 2018: Drugs/Biologicals/Radiopharmaceuticals/Radiologic Imaging Agents June 1-2, 2018: Durable Medical Equipment and Accessories/Orthotics and Prosthetics/Supplies/Other Additional information, include preliminary coding determinations, will be posted at least four weeks before each meeting on the CMS HCPCS website. [read post]
21 Feb 2012, 8:08 am
In response to concerns raised by the American Physical Therapy Association (APTA) and other associations, the Centers for Medicare and Medicaid Services (CMS) has revised interpretative guidelines (Transmittal 72) to eliminate the requirement that rehabilitation services furnished in outpatient hospital settings be ordered by a practitioner with medical staff privileges. [read post]
