Posts Tagged ‘Centers for Medicare & Medicaid Services’
CMS unveils proposed rules for Medicaid managed care plans
On May 26, The Centers for Medicare & Medicaid Services (CMS) released its long-awaited proposed rule, updating its Medicaid managed care organization regulations. The proposal is designed to “better align regulations and best practices to other health insurance programs, including the private market and Medicare Advantage plans, to strengthen federal and state efforts at providing…
Read MoreOIG cracks down on place-of-service overpayments
Is your practice using proper place-of-service codes? If not, you’re not alone. According to a new report from the HHS Office of Inspector General, Medicare contractors may have overpaid physicians to the tune of $33.4 million for incorrectly coded services provided between January 2010 and September 2012. Why? It appears that the services were performed…
Read MoreICD-10 implementation clock ticking
With the deadline for implementation of ICD-10 just five months away, a lot is being written about whether medical practices are prepared. As late as April 30, Rep. Ted Poe of Texas introduced a bill that would prohibit the Secretary of Health and Human Services from replacing ICD-9 with ICD-10 in implementing the HIPAA code…
Read MoreGAO: Government misspent billions on Medicare/Medicaid
Last year, Medicare financed health services for approximately 54 million elderly and disabled beneficiaries at a total cost of $603 billion. Of that, approximately $60 billion went toward improper payments, according to a report issued last week by the Government Accountability Office (GAO) Most of that misspent money, about $45.8 billion, went toward the Medicare…
Read MoreCMS says ICD-10 testing successful: Are you prepared?
The Centers for Medicare and Medicaid Services is reporting that it successfully completed the first week of end-to-end testing of the soon-to-be-implemented ICD-10 coding. The testing, which took place between Jan. 26 and Feb. 3, included 661 participants with about 1,400 National Provider Identifiers registered. They were split equally between direct submitters and clearing houses/billing…
Read MoreGAO: CMS ready for ICD-10, but are you?
There is good news for healthcare providers coming out of the Government Accountability Office: The Centers for Medicare and Medicaid Services is prepared for the switch to ICD-10 on Oct. 1, according to a newly released report. The 41-page report notes that CMS has undertaken “a number of efforts†to prepare for transition to the…
Read MoreCMS extends moratoria for home health agencies, ambulance suppliers
The Centers for Medicare and Medicaid Services (CMS) is continuing its crackdown on fraud and abuse and South Florida providers are, not surprisingly, on its hit list. CMS announced on Jan. 30, new temporary moratoria on the enrollment of home health agencies in four cities including Fort Lauderdale. It also is extending, for another six…
Read MoreCMS to modify requirements for Meaningful Use
Bowing to pressure from physician groups, the Centers for Medicare & Medicaid Services (CMS), announced on Jan. 29 that it would amend its requirements for healthcare providers to meet meaningful use in the Medicare and Medicaid Electronic Health Record (EHR) Incentive programs. Among the most significant of these changes is to shorten the Meaningful Use…
Read MoreCMS delays enforcement of Medicare Part D rule
The Centers for Medicare & Medicaid Services announced that it is delaying enforcement of the requirements in 42 CFR § 423.120(c)(6) for the Medicare Advantage and prescription drug benefit (Medicare Part D) programs until Dec. 1, 2015. In May, CMS finalized (CMS-4159-F), a rule aimed at combating fraud and abuse in the Part D program.…
Read MoreCMS cracking down on fraudsters
Federal agencies are stepping up their efforts to go after providers who engage in healthcare fraud and abuse. On Dec. 3, the Centers for Medicare & Medicaid services issued new rules designed to crack down on what the agency refers to as “bad actors,†as part of an effort to increase oversight of Medicare providers,…
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