Monica Wallace

Monica Wallace

McDermott Will & Emery

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CMS Issues Proposed - Skilled Nursing Facility Rule

On April 15, 2015, Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to address Skilled Nursing Facility (SNF) Medicare rate increases for fiscal year (FY) 2016, as well as to propose a variety of measures...more

4/24/2015 - CMS Healthcare Medicare Skilled Nursing Facility

CMS Proposes Rule to Expand Authorization Program, Solicits Comments on Implementation

On May 28, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS) published a proposed rule to establish a prior authorization process for certain durable medical equipment,...more

6/17/2014 - CMS DMEPOS Durable Medical Equipment Healthcare HHS Prior Authorization Social Security Act

OIG Proposes Rule to Expand Civil Monetary Penalties and Solicit Comments on Penalty for Failure to Report and Return Overpayments...

Department of Health and Human Services, Office of Inspector General’s (OIG) proposed rule expands the use of civil monetary penalties and solicits comments on the penalty for failure to report and return overpayments. ...more

5/29/2014 - Civil Monetary Penalty CMS Healthcare HHS OIG Overpayment

CMS to Postpone Denying Claims When Ordering/Referring Provider Not Enrolled in Medicare

The Centers for Medicare & Medicaid Services will implement edits on providers ordering/referring Part B, durable medical equipment and Part A home health agency claims effective January 6, 2014....more

12/3/2013 - CMS Denial of Benefits Medicaid Medicare

CMS Delays Edits to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare and Issues Proposed Rule on Enrollment...

The Centers for Medicare & Medicaid Services temporarily delayed the implementation of edits relating to ordering/referring practitioners that were scheduled to go into effect May 1, 2013, and issued a proposed rule with...more

5/13/2013 - Billing CMS Medicare

CMS to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare

Effective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will begin to deny Part B Durable Medical Equipment (DME) and Part A Home Health Agency (HHA) claims for services or supplies when the...more

3/20/2013 - CMS Durable Medical Equipment Home Health Agencies Medicare National Provider identifier

Overview of 2013 Final Rule on DME Written Order and Face-to-Face Encounter Requirements

In the 2013 Medicare Physician Fee Schedule final rule, the Centers for Medicare & Medicaid Services significantly expands the list of durable medical equipment (DME) items that will require a face-to-face encounter and...more

11/14/2012

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