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5 Nov 2014, 11:58 am
CMS also noted that certification, as opposed to re-certification, is typically considered to be whenever a new assessment is completed to initiate care. [read post]
30 Aug 2017, 6:30 am
” Addition of “Amended Review” to Re-Review Policy (Section 16.0) As fully explained in the Tower MSA article of 7/12/2017, “Second Chance with MSA Approval! [read post]
22 Dec 2023, 9:51 am
We’re not paying a management company … And if we need to make decisions here [about staffing], we’re able to have a discussion and go to our hospital CEO for the support that we need. [read post]
14 Jan 2014, 1:57 pm
For example, if a patient receives appropriate outpatient hospital care that crosses one midnight; and then the physician re-evaluates and determines that the patient needs hospital care that crosses a second midnight, the [read post]
14 Jan 2014, 1:57 pm
For example, if a patient receives appropriate outpatient hospital care that crosses one midnight; and then the physician re-evaluates and determines that the patient needs hospital care that crosses a second midnight, the [read post]
20 Apr 2020, 11:24 am
The post COVID-19 Update: CMS Issues Recommendations for Re-Opening Facilities for Non-Emergent Care appeared first on Health Law Pulse. [read post]
27 Jun 2012, 9:50 am
This is why the legal and insurance industries had better be formulating some reasonable standards to propose to CMS; otherwise, we could be facing CMS' all or nothing recovery model in all aspects of MSP enforcement, past and future, indefinitely.IN RE: E.B., A MINOR; Michael J. [read post]
5 Jul 2018, 2:41 am
CMS states that it wants “to ensure claims are paid appropriately and preserve the Medicare Trust Fund for future generations,” while making it easier for providers “to submit claims accurately and manage the audit process if you’re audited. [read post]
17 Jul 2018, 6:30 am
CMS does not have the resources to review every MSA. [read post]
11 Jun 2020, 9:00 am
This guide was released following CMS’s April 19 Phase I guidance for healthcare facilities on re-opening in-person healthcare in areas of low, or relatively low and stable incidents of COVID-19 cases. [read post]
30 Nov 2021, 3:30 am
If you’re the Centers of Medicare and Medicaid Services (CMS), perhaps you view the glass as half-full. [read post]
8 Oct 2014, 9:48 am
Among other things: CMS will add a new quality measure on antipsychotic medication use starting January 2015, and include claims-based data on re-hospitalization and community discharge rates in the future. [read post]
25 Feb 2016, 4:27 pm
Major provisions of the proposed rule include: A requirement for enrollees to report certain questionable affiliations and the corresponding potential for CMS to deny or revoke federal health care program enrollment if the agency determines an affiliation poses un undue risk of fraud, waste or abuse; The ability for CMS to revoke a physician or eligible professional’s Medicare enrollment if he/she has a pattern or practice of abusive ordering/certifying of Medicare Part A or… [read post]
4 May 2016, 4:21 pm
Well we’re halfway through the week, it’s “Star Wars” day (“May the Fourth be with you”), and we’re starting to see a lot of coverage of CMS’ latest announcement. [read post]
17 May 2011, 10:26 am
With an appeal here and a possible answer someday from the 6th Circuit in Hadden, we're getting closer and closer to a Supreme Court resolution of this long standing nightmare. [read post]
14 May 2009, 1:53 pm
CMS is preparing to re-launch its controversial competitive bidding program for Medicare suppliers of certain types of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). [read post]
14 Sep 2016, 6:41 am
In a web post, CMS explains that it is lifting the review suspension because the BFCC-QIOs: successfully completed re-training on the Two-Midnight policy; completed a re-review of claims that were previously formally denied; and initiated various provider outreach efforts related to this policy. [read post]
25 Sep 2018, 1:49 pm
CMS will accept comments on the proposed rule through November 19, 2018. [read post]
10 Aug 2009, 12:32 am
Re-insurance, Stop Loss Insurance, Excess Insurance, Umbrella Insurance, etc.7. [read post]
26 Nov 2019, 6:30 am
As a refresher, the Amended Review process in Section 16.2 allows a new MSA to be submitted following a prior approval if all of the following criteria are met: CMS has issued a conditional approval/approved amount at least 12 but no more than 72 months prior, The case has not yet settled as of the date of the request for re-review. [read post]
