News & Analysis as of

Reporting Requirements MACs

Poyner Spruill LLP

Updated Hospice Quality Reporting Program Notices of Noncompliance and Reconsideration Requests

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The Centers for Medicare and Medicaid Services (CMS) has issued notification letters to hospice providers that are not in compliance with the Hospice Quality Reporting Program requirements. According to CMS, all noncompliance...more

Poyner Spruill LLP

SNF Quality Reporting Program Notices of Noncompliance and Reconsideration Requests

Poyner Spruill LLP on

The Centers for Medicare and Medicaid Services (“CMS”) has issued notification letters to skilled nursing facilities (“SNFs”) that are not in compliance with the SNF Quality Reporting Program requirements. According to CMS,...more

King & Spalding

CMS Updates Rules for Reporting Adverse Legal Action

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On June 1, 2018, CMS issued further guidance for reporting and reviewing final adverse legal actions (ALAs) in provider enrollment applications. In Transmittal 797, which replaces Transmittal 784 to the Medicare Program...more

Baker Donelson

Moving? Selling? Don't Forget to Report Your CHOW to Medicare

Baker Donelson on

In a recent edition of MLN Connects, CMS reminded health care providers and suppliers of their obligation to report changes in ownership as part of their conditions of participation under Medicare....more

King & Spalding

Upcoming Cost Report Filings for FYE 12/31/2016 Subject to More Stringent Rules Prohibiting Payment of Items that Are not Claimed...

King & Spalding on

The CY 2016 OPPS Final Rule, issued on October 30, 2015, instituted new cost reporting rules prohibiting MACs from paying items that a provider has not claimed or protested on its as-filed cost report. Importantly, these...more

Foley Hoag LLP

Summary: PAMA Final Rule

Foley Hoag LLP on

Market Based Payment for Clinical Diagnostic Laboratory Tests - Summary - On June 17, 2016 the Centers of Medicare & Medicaid Services (CMS) issued the long awaited Medicare Clinical Diagnostic Laboratory Tests...more

King & Spalding

CMS Temporarily Suspends QIO Patient Status Reviews of Short Stay Inpatient Claims under the Two Midnight Rule

King & Spalding on

According to press reports, on May 4, 2016, CMS directed Beneficiary and Family Centered Care Quality Improvement Organizations (BFCC-QIOs) tasked with reviewing the appropriateness of short stay inpatient claims under the...more

King & Spalding

Health Headlines: Also in the News - January 2015

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MACS to Hold Certain 2015 Date-of-Service Claims – CMS announced on December 29, 2014, that Medicare Administrative Contractors will hold claims containing 2015 services paid under the Medicare Physician Fee Schedule (MPFS)...more

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