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Latest Posts › Centers for Medicare & Medicaid Services (CMS)

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New CMS Rule Requires Extrapolation of Medicare Advantage RADV Audit Findings

The Centers for Medicare and Medicaid Services (CMS) published its final rule regarding the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program in early February 2023. Among other matters, the final rule...more

2/15/2023 / Audits , Centers for Medicare & Medicaid Services (CMS) , Compliance , Department of Health and Human Services (HHS) , False Claims Act (FCA) , Medicare Advantage , Medicare Advantage Organizations (MAOs) , New Rules , Required Documentation , Risk Adjustment Formula

HHS to Distribute First Tranche of $100 Billion to Healthcare Providers for COVID-19 Losses

The Coronavirus Aid, Relief, and Economic Security Act, known as the “CARES Act,” which became law on March 27, 2020, appropriates $100 billion to the Public Health and Social Services Emergency Fund to reimburse providers...more

4/20/2020 / CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Fee-for-Service , Health Care Providers

Healthcare Industry Implications of the CARES Act

The Coronavirus Aid, Relief, and Economic Security Act, known as the “CARES Act,” became law on March 27, 2020. The CARES Act implements wide-ranging changes to law and funding designed to ameliorate the coronavirus...more

4/15/2020 / CARES Act , Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Health Care Providers , Medicaid , Medicare

CMS Adopts New “2 Midnights” Presumption For Inpatient Hospital Admissions

On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) issued an advance copy of its final rulemaking that adopts a new approach to evaluating the medical necessity of inpatient hospital admissions. ...more

8/9/2013 / Centers for Medicare & Medicaid Services (CMS) , Fraud , Healthcare , Hospitals , Medicare , Medicare Part A , Required Documentation

Hospitals Provided Temporary Relief In Medicare Rebilling Policy

The Centers for Medicare & Medicaid Services (CMS) released a ruling and an interim rule that, effective immediately, will allow hospitals to rebill certain inpatient hospital services as outpatient services for one year...more

3/21/2013 / American Hospital Association , Audits , Billing , Centers for Medicare & Medicaid Services (CMS) , Hospitals , Medicare

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