Corporate Compliance

Corporate Compliance Articles by Topic: Medicare Coverage and Reimbursement

Transmittals and MLN Matters articles: CMS issues RAC/ZPIC transmittal, issues MLN Matters articles, and more

  • Medicare Weekly Update, Issue 47, November 17, 2009

    On November 16, CMS issued a transmittal to update the claims processing system to apply the new...

CMS Public Events: Hospital Open Door Forum

  • Medicare Weekly Update, Issue 47, November 17, 2009

    The next Hospital & Hospital Quality Open Door Forum is scheduled for 2 p.m. Eastern, Thursday...

Transmittals and MLN Matters articles: CMS updates lab NCD software, issues special edition article, and more

  • Medicare Weekly Update, Issue 46, November 10, 2009

    On November 6th, CMS published an update to the Provider Reimbursement Manual (PRM) with Medicare...

Regulations: CMS extends comment period for proposed ESRD PPS

  • Medicare Weekly Update, Issue 46, November 10, 2009

    On November 4, CMS published a notice in the Federal Register to extend the comment period on its...

Regulations: CMS displays OPPS, MPFS final rules for 2010, and more

  • Medicare Weekly Update, Issue 45, November 3, 2009

    On October 30, CMS released a display copy of the OPPS final rule for CY 2010.

Note: CMS issues 2010 final rule for ambulatory surgery centers and most hospital outpatient departments

  • Medicare Weekly Update, Issue 45, November 3, 2009

    CMS has released a display copy of the outpatient prospective payment system (OPPS) final rule for...

Regulations: CMS announces inpatient hospital deductible and more

  • Medicare Weekly Update, Issue 44, October 27, 2009

    On October 22, CMS published in the Federal Register three notices to announce the inpatient...

Transmittals and MLN Matters articles: CMS updates interest rate, clotting factor fee, and more

  • Medicare Weekly Update, Issue 44, October 27, 2009

    On October 23, CMS issued a transmittal to update the reasonable charge for splints, casts...

CMS Public Events: Hospital & Hospital Quality Open Door Forum

  • Medicare Weekly Update, Issue 41, October 6, 2009

    The next Hospital & Hospital Quality Open Door Forum (HODF) is scheduled for Thursday, October...

Other Issuances: OIG issues 2010 Work Plan, CMS updates lab NCDs, and more

  • Medicare Weekly Update, Issue 41, October 6, 2009

    On October 1, the OIG issued its Work Plan for FY 2010.

Transmittals and MLN Matters articles: CMS updates drug HCPCS hook and hold, rescinds/replaces transmittals, and more

  • Medicare Weekly Update, Issue 40, September 29, 2009

    On September 25, CMS replaced its previous transmittal on LCD exceptions. It had previously sent...

Transmittals and MLN Matters articles: CMS rescinds/replaces transmittals, issues special edition MLN Matters

  • Medicare Weekly Update, Issue 39, September 22, 2009

    On September 18, CMS rescinded and replaced two previous transmittals related to FDG PET coverage.

Note: CMS clarifies RACs' "exception authority"

  • Medicare Weekly Update, Issue 39, September 22, 2009

    On September 11, CMS published Transmittal 302 that updated the Program Integrity Manual on Local...

Note: Never Events - Updated guidance on reporting surgical errors for Medicare inpatients

  • Medicare Weekly Update, Issue 38, September 15, 2009

    During the last few years, there has been considerable focus on certain events identified as...

Transmittals and MLN Matters articles: CMS releases MLN Matters articles

  • Medicare Weekly Update, Issue 37, September 8, 2009

    CMS released several MLN Matters articles related to transmittals previously outlined in Medicare...

CMS Public Events: Hospital Open Door Forum transcript, audio available

  • Medicare Weekly Update, Issue 37, September 8, 2009

    The transcript and audio of the August 26 Hospital Open Door Forum (ODF) conference call are now...

Transmittals and MLN Matters articles: CMS issues 5010 instructions, updates OPPS, I/OCE, and moreTransmittals and MLN Matters articles: CMS issues 5010 instructions, updates OPPS, I/OCE, and more

  • Medicare Weekly Update, Issue 36, September 1, 2009

    On August 28, CMS issued transmittal R549OTN, in which it provided instructions to the MACs for...

Note: Condition code 44 - The continuing saga

  • Medicare Weekly Update, Issue 36, September 1, 2009

    On Friday, CMS issued Medicare Claims Processing Manual (MCPM) transmittal 1803, which is the...

CMS Public Events: Hospital Open Door Forum

  • Medicare Weekly Update, Issue 35, August 25, 2009

    The next Hospital & Hospital Quality Open Door Forum (HODF) is scheduled for Wednesday, August...

Note: Inpatient HINNs - Protecting the hospital’s right to recover payment for non-covered services

  • Medicare Weekly Update, Issue 34, August 18, 2009

    Last week, I participated in an HCPro audioconference on HINNs. "HINN" stands for...

Note: CMS announces a coverage determination on the "screening virtual colonoscopy"

  • Medicare Weekly Update, Issue 33, August 11, 2009

    On August 7, CMS issued a transmittal (R105NCD) to implement its decision to maintain non-coverage...

Regulations: IRF PPS published in Federal Register

  • Medicare Weekly Update, Issue 33, August 11, 2009

    On August 7, the inpatient rehabilitation facility prospective payment system (IRF PPS) final rule...

Transmittals and MLN Matters articles: CMS maintains noncoverage of CTC for colorectal cancer and more

  • Medicare Weekly Update, Issue 33, August 11, 2009

    On August 7, CMS issued a transmittal to implement its decision to maintain noncoverage of computed...

Feds arrest dozens nationwide for Medicare fraud scheme

  • Compliance Monitor, Issue 31, August 5, 2009

    Continuing the trend of increased fraud enforcement, the Medicare Fraud Strike Force arrested 32...

Regulations: CMS issues 2010 final rule for IPPS, IRF PPS

  • Medicare Weekly Update, Issue 32, August 4, 2009

    On July 31, CMS issued a display copy of the 2010 IPPS final rule.

Note: Inpatient Prospective Payment System (IPPS) Final Rule Announced

  • Medicare Weekly Update, Issue 32, August 4, 2009

    On July 31, 2009, CMS issued the IPPS final rule announcing the changes that will affect the...

Transmittals and MLN Matters articles: CMS releases MLN Matters articles

  • Medicare Weekly Update, Issue 31, July 28, 2009

    CMS released two MLN Matters article related to transmittals previously outlined in Medicare Weekly...

Other Issuances: CMS posts NCD, OIG issues reports, ICD-9-CM errata available

  • Medicare Weekly Update, Issue 31, July 28, 2009

    On July 21, CMS posted an NCD for sleep testing for OSA.

MedicareFind tip: Zero in on your manual with sub-filters

  • Medicare Weekly Update, Issue 31, July 28, 2009

    CMS’ manual system is an important source of information and guidance — that’s...

Note: Critical access hospitals and billing for non-patient laboratory testing

  • Medicare Weekly Update, Issue 30, July 21, 2009

    In a May 12 post, clarification was given regarding a “non-patient” and reference...

Transmittals and MLN Matters articles: CMS implements NCD, releases MLN Matters article

  • Medicare Weekly Update, Issue 30, July 21, 2009

    On July 17, CMS issued two transmittals to implement its recent NCD for FDG PET for solid tumors...

Regulations: OPPS proposed rule available in Federal Register

  • Medicare Weekly Update, Issue 30, July 21, 2009

    On July 21, CMS published the 2010 OPPS proposed rule in the Federal Register. The proposed rule...

Note: More on condition code 44 and observation

  • Medicare Weekly Update, Issue 29, July 14, 2009

    We have received many questions on the articles we have published on the counting of hours of...

CMS Public Events: ODF conference call this week

  • Medicare Weekly Update, Issue 29, July 14, 2009

    The next Hospital & Hospital Quality Open Door Forum (ODF) conference call is scheduled for...

Transmittals and MLN Matters articles: CMS implements OSA NCD, prepares for lab NCD edit changes, and more

  • Medicare Weekly Update, Issue 29, July 14, 2009

    On July 10, CMS issued a transmittal to update the interest rate for overpayments and underpayments...

Regulations: CMS issues OPPS proposed rule for CY 2010, and more

  • Medicare Weekly Update, Issue 28, July 7, 2009

    On July 1, CMS issued a display copy of the OPPS proposed rule for CY 2010.

Transmittals and MLN Matters articles: CMS re-issues never events transmittals, implements appeals changes

  • Medicare Weekly Update, Issue 28, July 7, 2009

    On July 2, CMS replaced its previous transmittals on the recently issued NCDs for wrong surgery...

Other Issuances: CMS posts NCDs for surgical never events, issues lab NCD update, and more

  • Medicare Weekly Update, Issue 28, July 7, 2009

    On June 29, CMS posted on its Web site the three NCDs for surgical never events.  

Note: 2010 OPPS proposed rule released

  • Medicare Weekly Update, Issue 28, July 7, 2009

    This was a busy week, but the biggest news was the somewhat early release of the OPPS proposed rule...

Note: Inpatient Part B benefit - limited services payable under Part B to hospital inpatients

  • Medicare Weekly Update, Issue 27, June 30, 2009

    Although there were several transmittals and other CMS issuances published during the past week...

Transmittals and MLN Matters articles: CMS re-issues OPPS update, released MLN Matters article for never events NCDs, and more

  • Medicare Weekly Update, Issue 27, June 30, 2009

    On June 26, CMS instructed contractors to make system changes required for implementation of the...

Other Issuances: CMS updates FAQs

  • Medicare Weekly Update, Issue 27, June 30, 2009

    CMS issued several new/updated frequently asked questions (FAQ).

Note: Never Events - CMS issues surgical error NCDs and related guidance

  • Medicare Weekly Update, Issue 25, June 16, 2009

    In 2002, the National Quality Forum (NQF) published a list of 27 events identified as...

Transmittals and MLN Matters articles: CMS implements NCDs for surgical never events, and more

  • Medicare Weekly Update, Issue 25, June 16, 2009

    On June 12, CMS issued updates to the Claims Processing Manual and National Coverage Determinations...

Note: MedicareFind.com launches

  • Medicare Weekly Update, Issue 24, June 10, 2009

    This week, you’ll notice a difference in the Medicare Weekly Update.  I’m pleased...

Transmittals and MLN Matters articles: CMS releases quarterly HCPCS update information, revised guidance on medical record entries, and more

  • Medicare Weekly Update, Issue 24, June 9, 2009

    On June 5, CMS released a transmittal to implement the July 2009 update to HCPCS.

Note: New Modifiers for Outpatient Never Events; Billing for Hospital Acquired Conditions

  • Medicare Weekly Update, Issue 22, May 26, 2009

    This week, CMS published the July Integrated Outpatient Code Editor (I/OCE).  Although there...

Other Issuances: OIG reviews oxaliplatin billing, CMS posts decision memo on CTCs

  • Medicare Weekly Update, Issue 21, May 19, 2009

    On May 14, the OIG issued two reports on oxaliplatin billing. In both cases, the OIG determined...

Note: Clarification of reference (non-patient) laboratory testing

  • Medicare Weekly Update, Issue 20, May 12, 2009

    CMS released Transmittal 1729 to the Claims Processing Manual this week, implementing provisions of...

Note: Proposed FY 2010 IPPS Rule - An overview

  • Medicare Weekly Update, Issue 19, May 5, 2009

    On Friday May 1, CMS released the proposed inpatient prospective payment system (IPPS) rule for FY...

Regulations: CMS issued 2010 IPPS proposed rule, and more

  • Medicare Weekly Update, Issue 19, May 5, 2009

    On May 1, CMS released a display copy of the IPPS proposed rule for fiscal year 2010.

Other Issuances: OIG issues reports on oxaliplatin, E&M, and more

  • Medicare Weekly Update, Issue 19, May 5, 2009

    On April 23, the OIG released a report on outpatient payments for oxaliplatin made in 2004 and 2005...

Q&A: What is an invasive procedure?

  • Compliance Monitor, Issue 17, April 29, 2009

    Q: What is an invasive procedure?

CMS Public Events: Hospital Open Door Forum

  • Medicare Weekly Update, Issue 16, April 21, 2009

    The next CMS Hospital & Hospital Quality Open Door Forum conference call is scheduled for April...

Other Issuances: CMS releases updated lab NCD manual, posts FAQ on MUEs, ABNs

  • Medicare Weekly Update, Issue 16, April 21, 2009

    CMS has posted the April 2009 version of the NCD manual for clinical diagnostic laboratory services...

Note: Medically Unlikely Edits and ABNs

  • Medicare Weekly Update, Issue 16, April 21, 2009

    This was an especially light week for items from CMS for hospitals. This is, perhaps, because...

Note: Compliance with Condition Code 44 - A practical approach

  • Medicare Weekly Update, Issue 15, April 14, 2009

    This week, let’s continue our focus on the so-called Condition Code 44 process. If followed...

Transmittals: CMS lowers interest rate for overpayments and underpayments

  • Medicare Weekly Update, Issue 15, April 14, 2009

    On April 9, CMS lowered the interest rate for Medicare overpayments and underpayments from 11.375...

Other Issuances: OIG issues reviews of high-dollar claims, CMS updates FAQs

  • Medicare Weekly Update, Issue 15, April 14, 2009

    On April 9, the OIG released a review of high-dollar payments for Medicare outpatient claims...

Note: Condition Code 44 - Let's focus on process

  • Medicare Weekly Update, Issue 14, April 7, 2009

    This is the first of two additional Instructor’s Notes that will focus on Condition Code 44...

Other Issuances: CMS posts decision memo, updates FAQs

  • Medicare Weekly Update, Issue 14, April 7, 2009

    On April 3, CMS posted a final decision memo in which it announced revisions to Section 220.6 of...

Note: Observation with condition code 44 and physician supervision

  • Medicare Weekly Update, Issue 13, March 31, 2009

    Last week the American Health Lawyers Association held their annual Institute on Medicare and...

Note: CMS clarifies billing for devices and supplies

  • Medicare Weekly Update, Issue 12, March 24, 2009

    This week, CMS published an MLN Matters article related to the April update to the OPPS published...

Transmittals: CMS revises SOM, issues MLN Matters articles

  • Medicare Weekly Update, Issue 12, March 24, 2009

    On March 20, CMS issued a transmittal to change some portions of the State Operations Manual...

Victory Memorial hospital settles whistleblower case for at least $2.3 million

  • Compliance Monitor, Issue 11, March 18, 2009

    The United States has reached a $2.3 million settlement with Victory Memorial, a not-for-profit...

Note: Hospital compliance with Medicare's post acute transfer rules

  • Medicare Weekly Update, Issue 11, March 17, 2009

    Hospitals are ordinarily entitled to a full DRG payment when patients are discharged to their home...

Transmittals and MLN Matters articles: CMS issues CCI, I/OCE, OPPS updates, and more

  • Medicare Weekly Update, Issue 11, March 17, 2009

    On March 13, CMS issued its quarterly CCI edits update for April.

Other Issuances: OIG issues transfer policy review, CMS issues EMTALA memo

  • Medicare Weekly Update, Issue 11, March 17, 2009

    On March 11, the OIG issued a report in which it determined that hospitals improperly coded 15,051...

Transmittals and MLN Matters articles: CMS updates MPFS, issues MLN Matters articles, and more

  • Medicare Weekly Update, Issue 10, March 10, 2009

    On March 6, CMS issued a transmittal in which it instructed hospitals submit data on their FY 2006...

Other Issuances: CMS issues final decision memo

  • Medicare Weekly Update, Issue 10, March 10, 2009

    On March 3, CMS issued a final decision memo in which it establishes certain conditions of coverage...

Note: Application of critical care Correct Coding Initiative (CCI) edits to hospitals

  • Medicare Weekly Update, Issue 9, March 3, 2009

    Effective January 1, 2009, the CCI edits for evaluation and management (E&M), including...

Transmittals: CMS announces waived tests, releases MLN Matters articles

  • Medicare Weekly Update, Issue 9, March 3, 2009

    On February 27, CMS released a transmittal announcing new waived tests approved by the FDA under...

Other Issuances: CMS releases Heartsbreath NCD

  • Medicare Weekly Update, Issue 9, March 3, 2009

    On February 23, CMS posted an NCD for the Heartsbreath test for heart transplant rejection in which...

Note: Locality adjustment for Medicare Physician Fee Schedule-based payments

  • Medicare Weekly Update, Issue 8, February 24, 2009

    CMS issued Transmittal 1681 February 13, 2009, related to locality adjustment for payments made to...

Other Issuances: CMS updates FAQs, OIG releases audit reports, and more

  • Medicare Weekly Update, Issue 8, February 24, 2009

    CMS released several updated frequently asked questions (FAQ) last week, related to Medicare...

CMS Public Events: Hospital Open Door Forum

  • Medicare Weekly Update, Issue 8, February 24, 2009

    The next CMS Hospital & Hospital Quality Open Door Forum conference call is scheduled for...

Q&A: What is HETS?

  • Compliance Monitor, Issue 7, February 18, 2009

    Q: What is HETS? How do I connect to this system?

Transmittals: CMS issues wage index corrections, changes lab NCD edit software, and more

  • Medicare Weekly Update, Issue 7, February 17, 2009

    On February 13, CMS issued clarifying instructions on the calculation of payment amounts for...

Other Issuances: CMS issues proposed, final decision memos, and more

  • Medicare Weekly Update, Issue 7, February 17, 2009

    On February 13, CMS issued a memo in which it clarifies its enforcement approach to certain changes...

Other Issuances: CMS releases NCD for PTA

  • Medicare Weekly Update, Issue 5, February 3, 2009

    On January 26, CMS issued an NCD for PTA in which, consistent with its previously issued decision...

NCDs announced for three 'never events'

  • Healthcare Auditing Weekly, Issue 4, January 27, 2009

    CMS announced national coverage determinations (NCDs) for three preventable errors identified in...

Prepare for approaching ABN deadline

  • Medicare Weekly Update, Issue 4, January 27, 2009

    Medicare has been going through a number of transitions recently. One of these transitions relates...

Regulations: CMS issues OPPS corrections

  • Medicare Weekly Update, Issue 4, January 27, 2009

    On January 26, CMS published in the Federal Register technical corrections to the 2009 OPPS final...

Regulations: ICD-10 final rule published, CMS proposes cytology PT changes

  • Medicare Weekly Update, Issue 3, January 20, 2009

    HHS sets ICD-10-CM/PCS adoption for 2013, CMS proposes changes to cytology proficiency testing (PT...

Other Issuances: CMS finalizes noncoverage of surgical never events

  • Medicare Weekly Update, Issue 3, January 20, 2009

    On January 15, CMS issued national coverage determinations (NCD) finalizing its proposals not to...

Other Issuances: CMS selects final MACs, OIG issues report on high-dollar claims, and more

  • Medicare Weekly Update, Issue 2, January 13, 2009

    On January 8, CMS issued the first results of its Hospital Outpatient Quality Data Reporting...

Where to go to get your laboratory NCD information

  • Medicare Weekly Update, Issue 53, December 30, 2008

    This week, CMS published the laboratory Medicare National Coverage Determinations Coding Policy...

Transmittals: CMS maintains PTA NCD, updates cost report form and instructions

  • Medicare Weekly Update, Issue 53, December 30, 2008

    On December 24, CMS issued a transmittal maintaining its current NCD for PTA of the carotid artery...

Other Issuances: CMS updates lab NCD manual, OIG issues adverse events case study, and more

  • Medicare Weekly Update, Issue 53, December 30, 2008

    CMS has released its January 2009 update to the NCD manual for clinical diagnostic laboratory...

CMS talks quality in listening session

  • Healthcare Auditing Weekly, Issue 48, December 23, 2008

    CMS held a listening session December 18 regarding hospital-acquired conditions (HACs), never...

NP/PA supervision in provider-based departments

  • Medicare Weekly Update, Issue 52, December 23, 2008

    I thought I would do a follow-up to Hugh’s note last week about physician supervision. One of...

Transmittals: CMS announces new waived tests, updates clotting factor furnishing fee, and more

  • Medicare Weekly Update, Issue 52, December 23, 2008

    On December 19, CMS issued its annual update to the furnishing fee for clotting factor.

Other Issuances: CMS updates serum iron studies NCD, OIG publishes safe harbor notice, and more

  • Medicare Weekly Update, Issue 52, December 23, 2008

    On December 18, CMS extended coverage under the serum iron studies NCD to ICD-9-CM codes 285.22 and...

Nurse sentenced for Medicare fraud

  • Compliance Monitor, Issue 90, December 17, 2008

    Marie Weller King, registered nurse and owner of King and Associates, will serve 18 months in...

Physician supervision for on-campus provider-based departments

  • Medicare Weekly Update, Issue 51, December 16, 2008

    A colleague (another healthcare lawyer) contacted me last week to talk about CMS’s discussion...

Transmittals: CMS rejects TIPs coverage, implements changes to medical necessity edits for lab services

  • Medicare Weekly Update, Issue 51, December 16, 2008

    On December 12, CMS updated its Program Integrity Manual to reflect recent changes to its...

Other Issuances: CMS updates frequently asked questions, issues decision memo; OIG issues reports

  • Medicare Weekly Update, Issue 51, December 16, 2008

    On December 12, CMS issued 125 new/updated frequently asked questions related to Medicare...

Regulations: CMS publishes revised final wage indices and hospital reclassifications

  • Medicare Weekly Update, Issue 50, December 9, 2008

    On December 3, CMS published in the Federal Register revised final wage indices and hospital...

Other Issuances: CMS proposes NCDs for surgical never events, OIG issues Semiannual Report, and more

  • Medicare Weekly Update, Issue 50, December 9, 2008

    On December 3, the OIG issued its Semiannual Report to Congress for April 1–September 30 of...

CMS Public Events: HAC listening session

  • Medicare Weekly Update, Issue 50, December 9, 2008

    CMS has scheduled a listening session on hospital-acquired conditions (HAC) in inpatient and...

Strategies for Health Care Compliance December 2008

  • Strategies for Health Care Compliance, Issue 12, December 1, 2008

    Inside: Examine short stays, avoid overpayment Direct-to-consumer genetic testing is a state...

Imaging accreditation will be mandatory in 2012

  • Strategies for Health Care Compliance, Issue 12, December 1, 2008

    Your imaging facility is on the clock. The Medicare Improvements for Patients and Providers Act of...

OIG finds billions in inappropriate DSH payments

  • Healthcare Auditing Weekly, Issue 42, November 11, 2008

    In a review of Medicare capital disproportionate share hospital (DSH) payments, the OIG found that...

Regulations: No issuances this week

  • Medicare Weekly Update, Issue 45, November 11, 2008

    CMS issued no significant regulations affecting hospital billing this week.

Transmittals: CMS issues HCPCS update, updates therapy code list, and more

  • Medicare Weekly Update, Issue 45, November 11, 2008

    On November 7, CMS issued a transmittal implementing an update to HCPCS for 2009.

CMS Public Events: ODF call scheduled for November 17

  • Medicare Weekly Update, Issue 45, November 11, 2008

    The next CMS Hospital & Hospital Quality Open Door Forum conference call is scheduled for...

CMS releases display copy of CY 2009 MPFS, seeks comments on Stark exception

  • Compliance Monitor, Issue 84, November 5, 2008

    CMS releases display copy of CY 2009 MPFS, seeks comments on Stark exception

Other Issuances: OIG issues review of HIPAA security enforcement, reports on high-dollar payments

  • Medicare Weekly Update, Issue 44, November 4, 2008

    On October 30, the OIG issued a review of CMS’ oversight of the HIPAA security rule. The OIG...

CMS Public Events

  • Medicare Weekly Update, Issue 44, November 4, 2008

    CMS has no public events scheduled for this week.

Are hospitals improperly converting inpatient cases to observation?

  • Medicare Weekly Update, Issue 43, October 28, 2008

    It was recently brought to my attention that some (perhaps many) hospitals may be using the...

Regulations: No issuances this week

  • Medicare Weekly Update, Issue 43, October 28, 2008

    CMS issued no significant regulations affecting hospital billing this week.

Transmittals: CMS implements CWF edits, changes interpretive guidelines for hospital conditions of participation, and more

  • Medicare Weekly Update, Issue 43, October 28, 2008

    On October 24, CMS issued a transmittal recognizing four authoritative compendia for use in...

CMS Public Events

  • Medicare Weekly Update, Issue 43, October 28, 2008

    CMS has no public events scheduled for this week.

CMS Public Events

  • Medicare Weekly Update, Issue 42, October 21, 2008

    CMS has no public events scheduled for this week.

Watch for potential RAC trickle-down effect

  • Medicare Weekly Update, Issue 42, October 21, 2008

    I taught a Medicare course in Chicago last week. One of the course participants from California...

Transmittals: CMS updates interest rate for Medicare overpayments and underpayments, clarifies previous transmittal on CPAP therapy for OSA

  • Medicare Weekly Update, Issue 42, October 21, 2008

    On October 15, CMS issued a transmittal instructing Medicare contractors to implement an interest...

Other Issuances: CMS issues decision memo on PTA, OIG reviews high-dollar payments

  • Medicare Weekly Update, Issue 42, October 21, 2008

    On October 16, the OIG issued a report on high-dollar payments for inpatient and outpatient claims...

MLN Matters articles: CMS issues articles on lab NCD edits, FY 2009 IPPS changes

  • Medicare Weekly Update, Issue 41, October 14, 2008

    CMS released two MLN Matters articles last week related to transmittals previously announced in...

CMS Public Events

  • Medicare Weekly Update, Issue 41, October 14, 2008

    CMS has no public events scheduled for this week.

Tip: Guidelines for documenting screening treatment

  • Compliance Monitor, Issue 78, October 8, 2008

    Tip: Guidelines for documenting screening treatment

Busy week: OIG Work Plan, CMS' MUE list available

  • Medicare Weekly Update, Issue 40, October 7, 2008

    There were a number of significant regulatory developments last week, including the release of the...

Regulations: CMS issues wage indices, payment rates, and corrections for 2009 IPPS

  • Medicare Weekly Update, Issue 40, October 7, 2008

    On October 3, CMS published in the Federal Register a notice providing the wage indices, hospital...

Transmittals and MLN Matters articles: CMS updates IPPS, lab NCDs, and more

  • Medicare Weekly Update, Issue 40, October 7, 2008

    On October 3, CMS issued a transmittal implementing FY 2009 changes for IPPS hospitals. The...

Other Issuances: CMS publishes MUEs, OIG issues annual Work Plan, and more

  • Medicare Weekly Update, Issue 40, October 7, 2008

    On October 3, the OIG released a report on high-dollar payments that National Government Services...

CMS Public Events: ODF scheduled for October 9

  • Medicare Weekly Update, Issue 40, October 7, 2008

    The next CMS Hospital & Hospital Quality Open Door Forum conference call is scheduled for...

MLN Matters articles: CMS releases articles on OPPS, OCE updates

  • Medicare Weekly Update, Issue 39, September 30, 2008

    CMS released two MLN Matters articles last week related to transmittals previously announced in...

Other Issuances: CMS revises heart-related NCDs, announces 2009 deductible and coinsurance amounts

  • Medicare Weekly Update, Issue 39, September 30, 2008

    On September 26, CMS issued two revised NCDs, one for heart transplants and one for artificial...

CMS Public Events

  • Medicare Weekly Update, Issue 39, September 30, 2008

    CMS has no public events scheduled for this week.

Medicare Part B premiums remain the same in 2009

  • Healthcare Auditing Weekly, Issue 36, September 23, 2008

    CMS recently announced its premiums and deductibles for 2009 in a press release on the CMS Web site.

Transmittals and MLN Matters articles: CMS issues OPPS, NCCI updates, and more

  • Medicare Weekly Update, Issue 38, September 23, 2008

    On September 19, CMS released the fourth quarter update to the NCCI edits.

Other Issuances: OIG issues report on high-dollar payments

  • Medicare Weekly Update, Issue 38, September 23, 2008

    On September 15, the OIG issued a report on high-dollar payments for inpatient services processed...

CMS Public Events

  • Medicare Weekly Update, Issue 38, September 23, 2008

    CMS has no public events scheduled for this week.

Regulations: CMS publishes IRF PPS correction

  • Medicare Weekly Update, Issue 37, September 16, 2008

    On September 12, CMS published in the Federal Register a correction to the IRF PPS. The correction...

Transmittals and MLN Matters articles: CMS updates OCE, ASP drug pricing files, and more

  • Medicare Weekly Update, Issue 37, September 16, 2008

    On September 12, CMS rescinded its May 20, 2008, transmittal (Change Request 6012) regarding the...

CMS Public Events

  • Medicare Weekly Update, Issue 37, September 16, 2008

    CMS has no public events scheduled for this week.

Transmittals and MLN Matters articles: CMS issues revised ABN instructions, physician signature article, and more

  • Medicare Weekly Update, Issue 36, September 9, 2008

    On September 5, CMS released revised manual instructions on limitation on liability, including use...

CMS Public Events

  • Medicare Weekly Update, Issue 36, September 9, 2008

    CMS has no public events scheduled for this week.

CMS issues transmittal on physician signature requirements

  • Medicare Weekly Update, Issue 35, September 3, 2008

    As reported below, CMS issued a transmittal last week (Change Request 6100) updating Section 80.6.1...

Transmittals: CMS implements artificial heart NCD, clarifies physician signature requirements, and more

  • Medicare Weekly Update, Issue 35, September 3, 2008

    On August 29, CMS issued two transmittals implementing its May 1 NCD that established coverage for...

CMS Public Events

  • Medicare Weekly Update, Issue 35, September 3, 2008

    CMS has no public events scheduled for this week.