Payments to physicians, even for routine, necessary duties, may cause referrals to the entity making the payments to be "prohibited referrals" under the Stark Law. This means the hospital or other entity should not have...more
The Centers for Medicare & Medicaid Services (CMS) recently proposed a six-month delay for home health agencies (HHAs) to implement the revised conditions of participation (CoPs) that HHAs must satisfy to participate in the...more
The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule, 42 C.F.R. pt. 484, implementing significant changes to the conditions of participation (CoPs) that home health agencies (HHAs) must satisfy to...more
2/7/2017
/ Assessment ,
Centers for Medicare & Medicaid Services (CMS) ,
Conditions of Participation (CoP) ,
Emergency Response ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Home Health Agencies ,
Home Health Care ,
Infections ,
Medicaid ,
Medicare ,
Patient Rights ,
Performance Standards ,
Quality of Care Standards
On November 1, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the 2017 Medicare Outpatient Prospective Payment System (OPPS) Final Rule. One aspect of this rule is the implementation of payment decreases for...more
11/11/2016
/ Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Hospitals ,
Medicare ,
Off-Campus Departments ,
OPPS ,
Payment Rates
The Centers for Medicare & Medicaid Services (CMS) published the Reporting and Returning of Overpayments Final Rule (Final Rule) on February 12, 2016. The Final Rule implements Section 6402(a) of the Affordable Care Act,...more
4/12/2016
/ 60-Day Rule ,
Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
False Claims Act (FCA) ,
Final Rules ,
Health Care Providers ,
Medicare Part A ,
Medicare Part B ,
Overpayment Recovery Time Limits ,
Provider Self-Disclosure Protocol ,
Reporting Requirements
The Centers for Medicare & Medicaid Services (CMS) published the Reporting and Returning of Overpayments Final Rule (Final Rule) on February 12, 2016. The Final Rule implements section 6402(a) of the Affordable Care Act which...more
On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, a two-year budget deal with a key provision affecting hospitals and other health care providers. Effective January 1, 2017, the Act decreases the...more
11/4/2015
/ Bipartisan Agreement ,
Centers for Medicare & Medicaid Services (CMS) ,
Federal Budget ,
HCPCS ,
Health Care Providers ,
Healthcare ,
Hospitals ,
Medicare ,
MPFS ,
Obama Administration ,
OPPS ,
Physicians