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Healthcare ZPIC

Polsinelli

New Restrictions: CMS Limits Scope of Review on Redeterminations and Reconsiderations for Certain Audit Appeals

Polsinelli on

On August 13, 2015, the Centers for Medicare & Medicaid Services (CMS) issued instructions to Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) regarding the scope of review for...more

McAfee & Taft

CMS authorizes contractors to deny ‘related’ claims of physicians who are not undergoing review

McAfee & Taft on

The Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services recently issued Transmittal 505 modifying Section 3.2.3 of the Medicare Program Integrity Manual. CMS employs a variety of...more

King & Spalding

CMS Provides MACs, RACs, and ZPICs With Automatic Denial Authority for “Related” Claims

King & Spalding on

Effective March 6, 2014, Medicare contractors may automatically deny claims that are “related” to other claims that have been denied as a result of pre- or postpayment review. Contractors need not issue Additional...more

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