The article reports on the revisions made for the schedule of filing for Medicare fee-for service, which has been reduced to one calendar year in the U.S. under the Patient Protection and Affordable Care Act.EBSCO_bspNational Intelligence Report...
If you fail to send the timely NOA, you may request an exception, which, if approved, waives the consequences of late filing. The four circumstances that may qualify for an exception are: Fires, floods, earthquakes or other unusual events that inflict extensive damage to the HHA’s ability ...
enacted in BBA 99 to enable all hospitals, not just those hospitals filing 1996 cost reports, to be eligible for transitional payments under the PPS. Section 404. Application of Rules for Determining Provider-Based Status for Certain Entities. ...
The agency has also issued more strict prior authorization rules this year and cracked down on when MA plans must cover inpatient care. The health insurance industry has said the new rates will “put even more pressure on the benefits and premiums” of MA beneficiaries, a warning that ...
1.01 BLUE CROSS OF CALIFORNIA is a California corporation licensed by the California Commissioner of Corporations to operate a health care service plan pursuant to the Xxxx-Xxxxx Health Care Service Plan Act of 1975 and the Rules of the California Commissioner of Corporations promulgated thereunder (...
Until four years ago, the penalty for not securing qualified coverage was $695 per adult ($2,085 maximum) or 2.5% of total household income, whichever was higher. However, applicants were exempt from the penalty if your household income was lower than the federal income tax return filing thr...
Policyholders expect a timely resolution to their claims to get their lives back on track. The average claim processing time can vary from one insurance company to another and depends on the complexity of the claim. In general, insurance companies strive to streamline their processes to minimize ...
Congress, beset by frenzied lobbying by powerful special interest groups, would ultimately determine health care budgets and spending, as well as the rules and regulations that would govern care delivery by doctors, hospitals, and other medical professionals. Patients’ personal choices, as well as ...
There is no doubt that Congress has given CMS broad powers to enact rules and regulations governing the operation of the Medicare Program. CMS has used that authority to promulgate thousands of regulations and policies to govern, among other things, who is eligible to participate in the Medicare...