CMS Releases Medicare Outpatient Observation Notice Form
On December 8, 2016, the Centers for Medicare and Medicaid Services (CMS) published the Medicare Outpatient Observation Notice (MOON), which educates Medicare beneficiaries on the effect of outpatient...
View Article21st Century Cures: A Closer Look
On December 7, 2016, the US Congress enacted the 21st Century Cures Act, substantial legislation intended to accelerate “discovery, development and delivery” of medical therapies by encouraging...
View ArticleCMS Revises the Self-Referral Disclosure Protocol Requiring the Use of...
The Centers for Medicare and Medicaid Services (CMS) recently posted revisions to the Voluntary Self-Referral Disclosure Protocol (SRDP). In an attempt to streamline the self-disclosure process, CMS...
View ArticleOverview of 2013 Final Rule on DME Written Order and Face-to-Face Encounter...
In the 2013 Medicare Physician Fee Schedule final rule, the Centers for Medicare & Medicaid Services significantly expands the list of durable medical equipment (DME) items that will require a...
View ArticleCMS to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare
Effective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will begin to deny Part B Durable Medical Equipment (DME) and Part A Home Health Agency (HHA) claims for services or...
View ArticleCMS Delays Edits to Deny Claims When Ordering/Referring Provider Not Enrolled...
The Centers for Medicare & Medicaid Services temporarily delayed the implementation of edits relating to ordering/referring practitioners that were scheduled to go into effect May 1, 2013, and...
View ArticleCMS to Postpone Denying Claims When Ordering/Referring Provider Not Enrolled...
The Centers for Medicare & Medicaid Services will implement edits on providers ordering/referring Part B, durable medical equipment and Part A home health agency claims effective January 6,...
View ArticleOIG Proposes Rule to Expand Civil Monetary Penalties and Solicit Comments on...
Department of Health and Human Services, Office of Inspector General’s (OIG) proposed rule expands the use of civil monetary penalties and solicits comments on the penalty for failure to report and...
View ArticleCMS Proposes Rule to Expand Authorization Program, Solicits Comments on...
On May 28, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) published a proposed rule to establish a prior authorization process for certain durable...
View ArticleCMS Issues Proposed - Skilled Nursing Facility Rule
On April 15, 2015, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to address Skilled Nursing Facility (SNF) Medicare rate increases for fiscal year (FY) 2016, as well as to...
View ArticleCongress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget...
On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services...
View ArticleCMS Finalizes Prior Authorization Program for Certain DMEPOS Items
On December 30, 2015, the Centers for Medicare & Medicaid Services (CMS) published its final rule establishing a prior authorization program for certain durable medical equipment, prosthetics,...
View ArticleProgram Integrity Changes to the Medicare Provider Enrollment Process
On March 1, 2016, the U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) published a proposed rule (Proposed Rule) entitled “Medicare, Medicaid, and...
View ArticleOIG Issues Report on Provider-Based Facilities, Urges CMS to Make Changes
In Depth - On June 16, 2016, the US Department of Health and Human Services Office of Inspector General (OIG) posted a report examining the Centers for Medicare & Medicaid Services’ (CMS’s)...
View ArticleCMS Proposed Rule Implements Limitations on Medicare Payments for Off-Campus...
In Depth - Background - On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) released the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule, which includes proposed...
View ArticleNew Medicare Enrollment Requirements for MA Providers
In Depth - The Medicare Physician Fee Schedule proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on July 7, 2016, (the Proposed Rule) requires certain providers and...
View ArticleCMS Increase in Mandated Nursing Facility CMPs
The Centers for Medicare & Medicaid Services (CMS) recently published a letter to State Survey Agency Directors describing revisions to Chapter 7 of the State Operations Manual (SOM) to reflect...
View ArticleManaging the Transition to Transformation: Old Dog, New Tricks: Fraud and...
McDermott’s Managing the Transition to Transformation series is designed to help health systems and other health care industry leaders address the many challenges presented by the transformation in...
View ArticleCMS Releases CY 2017 Final Rule Implementing Changes to Outpatient...
The Centers for Medicare & Medicaid Services released the calendar year 2017 final rule implementing changes to the Medicare hospital Outpatient Prospective Payment System, or OPPS, including...
View Article‘Tis the Season for Giving: OIG Updates Policy on Gifts of Nominal Value to...
In Depth - On December 7, 2016, the Office of the Inspector General (OIG) of the US Department of Health and Human Services (HHS) issued a policy statement increasing its thresholds for gifts that are...
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