In the recently issued calendar year 2025 Physician Fee Schedule final rule (Final Rule), the Centers for Medicare & Medicaid Services (CMS) finalized a number of policies related to the Medicare Prescription Drug Inflation Rebate Program (the Program). CMS established...
This is the first major change to the requirements for long-term care facilities’ participation in Medicare and Medicaid involving staffing and facility assessments in more than eight years. In the preamble to the rule, CMS itself acknowledges that the changes in the rule will requir...
Centers for Medicare & Medicaid Services (CMS) that establishes minimum staffing requirements for nursing homes, aimed at ensuring safe and high-quality care for residents.Harris, EmilyJAMA: Journal of the American Medical Association
while CMS continues to build out its computer system in the background. Now, we are aware that there are new Section 111 Reporting requirements include the reporting of WCMSA amounts for all TPOC settlements involving current Medicare beneficiaries whether the WCMSA was submitted to...
Yet, “more work must be done,” said NAACOS CEO Clif Gaus in a statement on Monday, including making quality reporting requirements less strenuous for the groups. Recommended Reading Shared Savings ACOs saved Medicare $1.8B in 2022 By Emily Olsen • Aug. 25, 2023 CMS tweaks ACO REACH ...
The Centers for Medicare & Medicaid Services (“CMS”) has announced its proposed rules for the Hospital Outpatient Prospective Payment (“OPPS”) and Ambulatory Surgical Center (“ASC”) Payment Systems, as well as its calendar year (CY) 2024 proposed Physician Fee Schedule (“PFS...
May 1, 2024 Region 2 Close Out As of April 30, 2024, the Recovery Audit Contractor (RAC) Region 2 administrative period has ended. Cotiviti Region 2 audit claim questions should be directed to the Medicare Administrative Contractor (MAC). Current Region 2 audits are performed by Performant Rec...
The Centers for Medicare & Medicaid Services (CMS) published aFinal Ruleon April 4, 2024, that makes a number of changes to regulations governing the Programs of All-Inclusive Care for the Elderly (PACE). Among other things, the Final Rule gives CMS additional grounds on which to deny PACE...
These requirements must be implemented by Jan. 1, 2027, for Medicare Advantage organizations, state Medicaid and CHIP fee-for-service programs, Medicaid managed care plans other than nonemergency medical transportation, prepaid ambulatory health plans, CHIP managed care entities and QHP issue...
The Centers for Medicare and Medicaid Services is proposing standards for issuers and marketplaces, as well as requirements for agents, brokers, web-brokers, direct enrollment entities and assisters operating on theAffordable Care Actmarketplace in a Notice of Benefit and Payment Parameters for 2025...