Debra A. McCurdy
The Medicare Payment Advisory Commission (MedPAC) has released its June 2011 "Report to the Congress: Medicare and the Health Care Delivery System." The report includes a number of recommendations that have generated much controversy to address the growing use of ancillary services, particularly non-hospital diagnostic imaging services.
On June 6, 2011, CMS published a final rule to implement an Affordable Care Act (ACA) provision that prohibits Medicaid payments for care associated with “provider-preventable conditions” (PPCs).
On February 25, 2011, CMS published a proposed rule that would implement an Affordable Care Act (ACA) provision to allow states to provide Medicaid home and community-based attendant services and supports through the Community First Choice (CFC) state plan option.
On February 2, 2011, the Centers for Medicare & Medicaid Services is publishing a final rule implementing provisions of the Affordable Care Act (ACA) that strengthen provider and supplier screening provisions under the Medicare, Medicaid, and Children's Health Insurance Program (CHIP).
CMS has announced final federal share disproportionate share hospital (DSH) allotments for FY 2009 and the preliminary allotments for FY 2011.
CMS has posted an "emergency update" to the 2011 Medicare physician fee schedule (MPFS) files, reflecting recent statutory changes and certain technical corrections.
A new OIG report, “Questionable Billing for Medicare Outpatient Therapy Services,” reviews 20 counties with the highest Medicare outpatient therapy payments per beneficiary and overall high outpatient utilization levels in 2009.
CMS has issued a new transmittal to update its timeline for implementing claims edits that will deny claims for services ordered or referred by a physician or other eligible professional who does not have an approved file in PECOS.
On Thursday the House of Representatives overwhelmingly approved a bill (H.R. 4994) that averts a 25 percent Medicare physician fee schedule cut scheduled to take effect January 1, 2011 under the statutory “sustainable growth rate” formula.
On November 24, 2010, the Centers for Medicare & Medicaid Services (CMS) is publishing its final rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system rates and policies for calendar year (CY) 2011.