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Displaying records 1 to 20 out of 4182 results for "CMS final rule".
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SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
  CMS updates Conditions of Participation in Final Rule
NOVEMBER 4, 2016
  CMS pushes SNFs toward payment reform in FY 2016 PPS final rule
SEPTEMBER 4, 2015
  CMS publishes corrections to RUG-IV federal per diem rates & MDS item in SNF PPS final rule
OCTOBER 5, 2018
  CMS final rule makes changes to how physicians are paid, delays E/M coding reform
NOVEMBER 2, 2018
The Centers for Medicare & Medicaid Services has released its final rule on Medicaid.  
NOVEMBER 13, 2015
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017
On October 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and Office of t
OCTOBER 9, 2015
The CMS made hospital quality improvement a major part of its fiscal year 2015 Inpatient Prospect
AUGUST 12, 2014
CMS finalized changes to multiple quality measures in the cms.gov/Medicare
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule this week that would
APRIL 21, 2016
On November 16, CMS issued the final rule for bundled payment demonstration (lower extremity) ef
DECEMBER 4, 2015
Agencies can breathe a deep sigh of relief. CMS won’t launch its drastically revised home h
CMS attempted, once again, to resolve ongoing patient status confusion—this time in its Out
By Steven Andrews Despite dealing with the final touches for ICD-10 implementation, provi
By Steven Andrews   Most policies in the OPPS final rule are not e
CMS continues to move toward increased packaging with its policies in the
JULY 8, 2015
JUSTCODING
On May 23, 2014, there was a new federal rule issued that requires physicians, including p
It’s finally here. CMS’ new Emergency Preparedness rule goes into effect on W
NOVEMBER 16, 2017
CMS continues the expansion of pay-for-performance (P4P) programs in the 2015 IPPS final r
AUGUST 27, 2014
JUSTCODING
CMS continues the expansion of pay-for-performance (P4P) programs in the 2015 IPPS final rule. By
The 2015 OPPS proposed rule introduced Comprehensive APCs and more packaging that could im
The Substance Abuse and Mental Health Services Administration (SAMSHA) released a final rule upda
It’s finally here. CMS’ new Emergency Preparedness rule goes into effect on W
NOVEMBER 14, 2017
CMS finalized changes for conditional packaging of ancillary services in the 2015 OPPS fin
CMS announced this week an expected cms.gov/Research-Statistics-Data-and-Sys
While CMS’ new payment rule bundling hip and knee replacement surgeries may have sparked so
DECEMBER 15, 2015
On May 3, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a final rule (
  Excerpts from the final rule: What's changing?
NOVEMBER 11, 2016
  Advancing care coordination through episode payment models final rule
FEBRUARY 10, 2017
The 2015 IPPS final rule, released August 4, focuses on quality initiatives and includes n
  Providers expected October 1, 2015, to be the new ICD-10 compliance date and CMS
The Centers for Medicare & Medicaid Services (CMS) today issued final regulations for the Med
CMS introduced several new HCPCS codes and added comprehensive APCs (C-APC), including one for ob
NOVEMBER 11, 2015
JUSTCODING
  By Steven Andrews   CMS announced this week an expe
The Center for Medicare & Medicaid Services (CMS) has released the finalized prospective paym
CMS cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items
NOVEMBER 4, 2015
JUSTCODING
CMS finalized several changes to the Hospital Outpatient Quality Reporting (OQR) program i
In its final rule about lessening health care providers’ burden, CMS estimates providers wi
Providers anticipated an update to the 2-midnight rule in the 2016 IPPS final rule release
CMS and the Office of the National Coordinator (ONC) released final rules October 6 with the inte
CMS yesterday announced a proposed rule on the adoption of the 2012 editions of the Life Safet
APRIL 15, 2014
CMS continues the expansion of pay-for-performance (P4P) programs in the 2015 IPPS final rule. By
CMS promised in May that a new ICD-10 implementation date would be revealed in the "n
October 1, 2015, will be the new ICD-10 implementation date, according to the final rule,
AUGUST 6, 2014
JUSTCODING
CMS updates the inpatient prospective payment system (IPPS) annually. In simplest terms,
As part of the changes in its recent final rule, CMS has eliminated the requirement that ambulat
CMS and the Office of the National Coordinator (ONC) released final rules October 6 with the inte
By Steven Andrews   Small tweaks to the 2-midnight rule in the 201
  By Steven Andrews, Editor   CMS’ finalization
CMS’ finalization of its comprehensive APC (C-APC) policy represents the most radical change f
On July 29, CMS issued a final rule (CMS-1645-F) outlining FY 2017 Medicare payment policies and
AUGUST 5, 2016
CMS has finalized its plan to cancel four mandatory episode payment models for common cardiac and
A significant portion of updates in the Fiscal Year 2015 IPPS final rule pertain to the Ho
AUGUST 7, 2014
Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates,
A proposed payment rule posted earlier this week outlines the CMS’ plan to allow physicians
A significant portion of updates in the Fiscal Year 2015 IPPS final rule pertain to the Hospital
What potential impact does the final rule on overpayments have on home health agencies? F
CMS finalized a new data collection requirement for services performed in off-campus, prov
NOVEMBER 12, 2014
JUSTCODING
CMS reintroduced Comprehensive APCs for device-dependent APCs with additional refinements
One day after an apparent stealth announcement of the new ICD-10 compliance date, CMS confirmed O
  CMS Finalizes the New Medicare Quality Payment Program
OCTOBER 28, 2016
CMS’ recently released 2015 IPPS final rule focuses on quality initiatives mandated by the
CMS makes policy and payment changes to the Medicare Physician Fee Schedule for 2015
by Josh Poltilove CMS has just given itself an additional year — until Nov
CMS' introduction of the 2-midnight rule in the 2014 IPPS final rule makes properly identi
CMS removed two add-on procedure codes from the inpatient-only list in the 2015 OPPS final
  SNF PPS final rule for 2017 brings increased rate but new challenges
OCTOBER 7, 2016
CMS’ 2014 IPPS Final Rule redefined the criteria for inpatient admission when it implemente
Q: In regards to the new CMS requirements regarding corridor projections, will alcohol-based hand
OCTOBER 20, 2016
On November 16, CMS posted the final rule with comment period addressing changes to the physician
After last year's OPPS proposed rule debacle, which included a later-than-usual release, d
CMS announced proposed changes to the Medicare long-term care requirements that would reform &ldq
SEPTEMBER 6, 2019
CMS continued its focus on improving the quality of patient care in the
OCTOBER 7, 2015
JUSTCODING
CMS revisions regarding therapeutic diet orders may give MSPs plenty to chew on
NOVEMBER 1, 2014
In a highly-anticipated move expected to significantly affect the regulatory rules that hospitals
MAY 5, 2016
In a highly-anticipated move expected to significantly affect the regulatory rules that hospitals
MAY 5, 2016
By Steven Andrews, Editor   One of CMS' proposals in the
CMS has included several proposals in the
CMS extends coverage of aprepitant for chemotherapy-induced emesis 
Facilities have less than 20 days to fully comply with CMS’ new emergency preparedness rule
OCTOBER 26, 2017
  CMS recently announced a finalized rule allowing hospitals more flexibility meet
SEPTEMBER 4, 2014
Final Rule Released After receiving 118 comments from the public, the Cen
CMS CoPs New final rule refines and redefines medical staff
AUGUST 1, 2014
The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for H
  The Centers for Medicaid and Medicare Services (CMS) issued a draft rule late Fr
APRIL 14, 2015
A newly proposed rule by CMS would put into effect new discharge planning requirements that the a
SEPTEMBER 26, 2019
As we continue our crawl (albeit an accelerated one) towards CMS adoption of the 2012 edition of
MAY 5, 2016
by Kirsten Dize CMS has eased off of plans to implement an 8.01% decrease i
The implementation of comprehensive APCs (C-APCs) in the 2015 OPPS final rule likely wasn'
  New CMS rule contains changes to binding arbitration clauses
SEPTEMBER 30, 2016
On March 20, CMS posted a notice in the Federal Register correcting technical errors in
On Thursday evening, CMS confirmed that it plans to implement ICD-10 as soon as it is allow
The release of the final rules for the Medicare Access and CHIP Reauthorization Act of 2015 (MACR
CMS 2015 SNF PPS final rule to increase payments to skilled nursing facilities
OCTOBER 1, 2014
CMS announced on September 8 that it had finalized new emergency response requirements for health
SEPTEMBER 13, 2016
Although the final rule contained several notable changes to the proposed VBP pilot set to launch
For many, this is the time of year when the latest updated rules, regulations, and payment rates
  CMS removed two procedures from the inpatient-only list and added one in the
NOVEMBER 19, 2014
JUSTCODING
CMS finalized its proposal to reduce the conversion factor by 2% to account for its overestimat
According to CMS’ final rule, 35 OASIS items would be deleted or modified for 2019. NAHC be
CMS issued the fiscal year (FY) 2017 IPPS proposed rule yesterday with updates to several quali
In January, I wrote about the perfect storm that led to the release of the 2014 OPPS final
CMS pushed back the deadline for physicians to enroll to prescribe Medicare Part D drugs. Physici
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017 a
Medicare regulations surrounding the 2-midnight rule are continually evolving, making it more imp
CMS solidifies a fix to the COT OMRA policy in 2015 final rule
NOVEMBER 1, 2014
Editor’s note: A final rule change issued last month by CMS could have a significant im
Now that the CMS has adopted the 2012 Life Safety Code (LSC), safety experts are looking
AUGUST 31, 2016
The Centers for Medicare & Medicaid Services (CMS) have released new home health Conditions o
In response to CMS’ final emergency preparedness rule issued earlier this month,
DECEMBER 1, 2017
On April 10, 2020, CMS issued a proposed rule
CMS will delay implementation of a chart-abstracted sepsis measure included in the IPPS fi
SEPTEMBER 10, 2014
JUSTCODING
CMS hosts a national provider call on transitioning to ICD-10 Wednesday, November 5, at 1:30 p.m.
CMS will host a national provider call on transitioning to ICD-10 at 1:30 p.m. (Eastern) Wednesda
OCTOBER 22, 2014
JUSTCODING
by Josh Poltilove In the short term, a new MLN Matters article announcing CMS wi
CMS continued its focus on improving the quality of patient care in the
SEPTEMBER 9, 2015
JUSTCODING
CMS has issued new information on the training and testing requir
APRIL 4, 2017
October 1, 2015, will be the new ICD-10 implementation date, according to the final rule, Adminis
CMS proposed that a new HCPCS modifier be appended to every code for a service furnished i
CMS finalizes emergency preparedness of Medicare/Medicaid-certified facilities
Provider-based clinics and departments are increasingly common at hospitals, but the rules for pr
CMS outlined how to access updates to ICD-10 Local Coverage Determinations (LCDs) in its M
JUNE 25, 2014
JUSTCODING
CMS released its fiscal year (FY) 2016 IPPS proposed rule, and announced changes to MS-DRGs and t
On January 28, CMS posted a fact sheet regarding a proposed rule that would update the methodolog
HOP Panel summer meeting scheduled CMS announced the summer meeting of
In a highly-anticipated move expected to significantly affect the regulatory rules that hospitals
CMS proposed a new HCPCS modifier be appended to every code for a service furnished in a h
FEBRUARY 4, 2015
JUSTCODING
The new ICD-10-CM/PCS implementation date looks to be October 1, 2015. CMS mentioned October
by Kirsten Dize After four years, a proposed rule and a deadline extension, CMS
On March 8, CMS posted a document in the Federal Register correcting technical and typog
CMS announces final regulatory changes affecting Medicare Parts C and D
AUGUST 1, 2014
CMS extends coverage for aprepitant for chemotherapy-induced emesis On
CMS refined and updated its Comprehensive APC policy in the
SEPTEMBER 3, 2014
JUSTCODING
One on One Education   On October 31, CMS released a c
Changes to the definition of one-on-one education On October 31, CMS re
Implement operating rules - Phase III ERA EFT: CORE 360 Uniform Use of Claim Adjustment
With quarterly code updates and other regulatory changes from CMS throughout the year, the
The implementation of comprehensive APCs (C-APCs) in the 2015 OPPS final rule likely wasn'
CMS updates Program Integrity Manual On May 2, CMS released a change re
On November 16, 2015, the Centers for Medicare & Medicaid Services (CMS) issued the final rul
CMS posts final decision on HIV screening   On April 13, CMS posted a final dec
This April, CMS sent out a memo with big proposals for accrediting organizations (AO). If passed,
JULY 11, 2017
The July quarterly I/OCE update from CMS brought few new APCs or edit updates, but did del
CMS may consider delaying implementation of the Medicare Access and CHIP Reauthorization Act (MAC
  CMS Issues Proposed Rule to Increase Patients' Health Insurance Choices for 2018
FEBRUARY 16, 2017
  RCS-1 CMS case-mix pre-rule: Get ready for big changes
  MedPAC comments on CMS’s proposed rule on Medicare Part C and Part D
JANUARY 5, 2018
CMS revises coverage of cardiac rehabilitation programs On August 29, C
CMS has clarified some points related to homebound status and telehealth use to help home health
In response to CMS’ final emergency preparedness rule issued earlier this month,
SEPTEMBER 26, 2017
 CMS proposes aligning its conditional packaging logic with how it applies packaging to labs
The July quarterly I/OCE update from CMS brought few new APCs or edit updates, but did del
A bill that allows CMS to expedite physicians’ applications for a meaningful use hardship e
DECEMBER 29, 2015
Long-anticipated rule change will affect how hospitals plan for emergencies and disasters
DECEMBER 22, 2016
By Steven Andrews CMS did not propose making any radical changes to comp
Last Tuesday, CMS issued cms.gov/Regulations-and-Guidance/Guidance/Transmitta
  cms.gov/Medicare/Coding/ICD10/Downloads/PartialCodeFreeze.
MAY 30, 2014
Last Friday, CMS cms.gov/Research-Statistics-Data-and-Systems/Monitori
CMS posted updated versions of all the guidance documents posted on the cms.g
MARCH 26, 2014
JUSTCODING
  CMS and AMA announce efforts to ease transition to ICD-10 for providers
CMS releases July 2014 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files
cms.gov/apps/ama/license.asp?file=/Medicare/Medicare-Fee-for-Service-P
Long-anticipated rule change will affect how hospitals plan for emergencies and disasters
DECEMBER 22, 2016
Correction notice to IPPS final rule On March 18, CMS and HHS issued a
Home health agencies can seek a little comfort in the relaxed provisions that CMS has put in plac
The Centers for Medicare & Medicaid Services (CMS) released final Medicare Advantage (MA) and
APRIL 17, 2015
Final PPS rule: OASIS   by Kirsten Dize Many items will be el
  CMS' 2014 IPPS final rule redefined inpatient admissions when it implemented the
The Centers for Medicare & Medicaid Services (CMS) has issued an updated version of the Hospi
CMS bumps up SNF payment rate increase in FY 2015 proposal
AUGUST 1, 2014
In a new blog post, CMS announced that it was extending its electronic clinical quality measure (
JANUARY 24, 2017
CMS indicated in the 2014 OPPS Final Rule that it will implement 29 new device-dependent c
For 2015, CMS finalized changes to reconfigure and consolidate ophthalmology and gynecolog
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due t
On August 6, CMS released a change request amending payment files that were issued to contractor
CMS is considering waiving the three-day hospital stay rule, required before a patient can be re
JANUARY 29, 2016
Time’s almost up: CMS emergency prep CoPs kick in soon Th
OCTOBER 1, 2017
Under the rule, an “overpayment” means any funds that a “person” has rece
SEPTEMBER 6, 2016
Providers probably weren't surprised that CMS continued its push to increase packaging in
    The 2016 OPPS proposed rule released July 2 is deceptively short
AUGUST 19, 2015
JUSTCODING
by Kirsten Dize CMS is seeking to reduce agency payments even more than expected
  CMS released MLN Matters® cms.gov/Outreach-and-Ed
by: Josh Poltilove During a Feb. 28 open door forum, CMS provided details about ho
Physician groups and other stakeholders continue to respond to CMS’ release of  the
CMS updates Program Integrity Manual On November 26, CMS release
CMS has released additional resources to assist eligible professionals (EP) participating in its
DECEMBER 15, 2015
On December 18, 2015, CMS posted the draft Quality Measure Development Plan, a strategic framewo
  In the 2016 IPPS final rule, CMS added three new claims-based measures and one s
OCTOBER 7, 2015
JUSTCODING
CMS issued its final rule, Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursi
NOVEMBER 15, 2019
It’s getting closer to the end of the value-based purchasing pilot program and CMS
CMS finalizes shorter risk period for overpayments The Centers f
by Josh Poltilove CMS is proposing to eliminate three requirements it has deemed
Q: Did CMS make any changes to the packaging of skin substitutes in the lates
CMS needs to evaluate, clarify, and modify sections of the Notice of Observation Treatment and Im
ESRD PPS and Quality Incentive Program (QIP) On July 1, CMS posted the E
Last Thursday, CMS issued a cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets
CMS releases July update to Medicare Physician Fee Schedule database 
The final interpretive guidelines for the revised Home Health Conditions of Participation (CoPs)
With the ICD-10 implementation date set for October 1, 2015, CMS has continued its efforts to pro
DECEMBER 30, 2014
CMS posts final decision on HIV screening   On April 13, CMS poste
A federal judge, finding in favor of hospitals, rejected CMS’s arguments that it met all le
  CMS has instructed MACs to reprocess claims and providers to reimburse beneficia
On June 12, CMS rescinded Transmittal 3205, dated February 27, 2015, and replaced i
On February 19, CMS released a change request amending payment files issued to contractors based
The Provider Roundtable (PRT) was established in 2003 to give CMS the benefit of providers' input
CMS has finalized a decision to make 19 OASIS items — 48 data elements &mdash
The latest rules proposed this spring for the electronic health records (EHR) incentive programs
Just in time for the holidays, CMS is offering the gift of a newly revised State Operations Manua
DECEMBER 23, 2019
CMS is expanding the information available on its
DECEMBER 15, 2015
CMS issues change request for lumbar decompression coverage On May 16,
CMS released the cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Ins
While the 2017 OPPS proposed rule includes a variety of tweaks and augmentations to existing regu
CMS extended the deadline for hospitals and EPs to attest 2015 meaningful use data to
FEBRUARY 23, 2016
With the ICD-10 implementation date set for October 1, 2015, CMS has continued its efforts
DECEMBER 23, 2014
JUSTCODING
by Megan Pielmeier CMS is moving full steam ahead toward implementation of the P
On November 16, CMS released
DECEMBER 15, 2015
  Hospice Final Rule for 2017 raises payments  
JULY 31, 2016
Hospice Final Rule for 2017 raises payments Last Friday, CMS issued a fin
On May 2, CMS released a change request to update various sections of Chapter 15 of t
CMS releases overview of Physician Feedback and Value-Based Modifier Programs
By Steven Andrews, Editor   Acts of Congress superseding CMS
A provision in CMS’ new rule to modify or eliminate unnecessary regulations will ease requ
CMS released cms.gov/Medicare/Coding/OutpatientCodeEdit/OCEQtrReleaseS
APRIL 29, 2015
JUSTCODING
Home health and hospice providers urged CMS to consider permanent adjustments to relax telehealth
On December 3, 2014, CMS Administrator Marilyn Tavenner announced new rules that strengthe
DECEMBER 5, 2014
In the final 2018 outpatient prospective payment system (OPPS) rule released by CMS, total knee a
MARCH 15, 2019
Hospitals may find themselves directly in the line of fire as CMS ramps up its oversight of The J
DECEMBER 1, 2018
Hospitals may find themselves directly in the line of fire as CMS ramps up its oversight of The J
DECEMBER 1, 2018
by Roy Edroso A sweeping new Medicare enrollment final rule with comment period
CMS' introduction of the 2-midnight rule in the
JULY 16, 2014
JUSTCODING
A proposed CMS change to the 2017 Medicare Physician Fee Schedule will require surgeons document
SEPTEMBER 13, 2016
Q: We don’t quite understand the CMS' new Comprehensive APCs (C-APC) and how to c
by Josh Poltilove Editor's note: CMS and its contractor, the RAND Corporation, explai
2015 annual update to the therapy code list released On November 14, CMS released a
CMS releases overview of Physician Feedback and Value-Based Modifier Programs On Feb
Signature requirements On July 24, CMS released a change request to allo
The Department of Labor’s (DOL) final rule, issued this week, increases minimum salary req
Implementation of NACHA operating rules for healthcare electronic funds transfers
  cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-m
A proposed rule (CMS-5524-P) released by CMS on August 15, 2017 would make the Comprehensive Care
The cms.gov/Medicare/Coding/OutpatientCodeEdit/OCEQtrReleaseSpecs.html
FEBRUARY 18, 2015
JUSTCODING
The CMS last week issued a rule designed to save $660 million annually and $3.2 billion over five
CMS update Program Integrity Manual (PIM) On November 26, CMS re
Due to a proposed change to the two-midnight rule, CMS has further delayed enforcement o
AUGUST 14, 2015
By A.J. Plunkett (aplunkett@decisionhealth.com) Expect CMS to continue i
NOVEMBER 10, 2019
Last Tuesday, a CMS change request (cms.gov/Regulations-and-Guidance/
  Last Thursday, CMS issued a proposed rule that would update fiscal year (FY) 201
As CMS pushes the OPPS from a fee-for-service program toward more of a true prospective pa
As CMS pushes the OPPS from a fee-for-service program toward more of a true prospective pa
Update to CMS publication 100-08, Program Integrity Manual, Chapter 3, section 3
CMS releases April 2015 I/OCE specifications On March 13, CMS released a notification to p
  CMS releases coverage criteria for TAVR volume requirements 
CMS estimates the median length of days for request for anticipated payment (RAP) submission is 12 d
According to the Federal Register, CMS is proposing a rule that would update the payment rates us
APRIL 24, 2015
CMS posts July update to Medicare Physician Fee Schedule Database On June 6, CMS rel
Update to surety bond collection procedures On May 16, CMS released a change request
Home Health Star Rating previews are now available to agencies CMS has an
You should review the final CoPs and the draft interpretive guidelines. Sections
Change allows hospices to bill directly for preventive vaccines CMS has issued
OCTOBER 7, 2015
JUSTCODING
CMS releases April 2015 I/OCE specifications On March 13, CMS released
On July 28, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a notice updatin
by Kirsten Dize CMS released the final OASIS-D guidance manual less than two wee
After several requests, CMS finally issued a waiver for some — but not all — equipmen
MAY 8, 2020
The cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R
MARCH 19, 2014
JUSTCODING
Use of claims data could soon expand to a host of new entities under proposed rules released
  The January 2014 update to the cms.gov/Medicare/Coding/Nati
CMS should have addressed the 2-midnight rule, but didn’t in the fiscal year 2016 IPPS prop
  Since January, providers have been struggling to reconcile conflicts between CMS
APRIL 30, 2014
JUSTCODING
The cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R
JULY 23, 2014
JUSTCODING
Q: Did CMS increase packaging for surgical procedures in 2014? Our surger
CMS updates interest rate for Medicare overpayments and underpayment 
 by Steven Andrews cms.gov/Research-Statistics-Data-and-System
BY A.J. PLUNKETT (APLUNKETT@H3.GROUP) Expect CMS to continue pressuring
DECEMBER 1, 2018
CMS updates influenza vaccine payment allowance  On September 3, C
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due t
OCTOBER 1, 2014
JUSTCODING
CMS allows contractors to use alternate medical documentation to ID illegible signatures
  CMS made relatively few changes in the cms.gov/Regulations-a
MAY 28, 2014
JUSTCODING
The American Hospital Association (AHA) asked CMS to include potential payment solutions for shor
CMS refined and updated its Comprehensive APC policy in the 2015 OPPS proposed rule releas
by A.J. Plunkett (aplunkett@decisionhealth.com) CMS is revising its
APRIL 26, 2020
The 2-midnight rule may get a little tweak if the proposals in
During the call on 5/14/15, CMS unpacked the proposed rule provisions a bit. Questions cam
Based upon a data analysis, CMS concluded that on average the first 30 days of an episode were mo
CMS is proposing a new status indicator to be assigned to laboratory tests so when the tes
AUGUST 19, 2015
JUSTCODING
The 2016 OPPS proposed rule released July 2 is deceptively short, but packs a punch. CMS i
CMS updates information for billing screening services On April 3, CMS
CMS officially declared October 1, 2015, the new ICD-10 implementation date with the publi
Last week, CMS published a list of proposed rule changes for
JUNE 21, 2016
CMS sets sights on future quality, payment initiatives in 2016 SNF PPS proposed rul
A proposed rule would expand access and use of claims data and analysis, cms
A new set of claims transaction rules has been approved by CAQH Committee on Operating Rules for
Last week, CMS proposed a new rule intended to boost the success of Accountable Care Organiz
On July 16, 2015, the Centers for Medicare & Medicaid Services (CMS) published propose
SEPTEMBER 25, 2015
To help reduce adverse events and readmissions, a rule proposed by CMS and published this week wo
NOVEMBER 3, 2015
CMS updates information for billing screening services On April 3, CMS released a c
Congress may be stepping in to once again delay a policy that CMS said would not face any
NOVEMBER 12, 2014
JUSTCODING
The 2015 OPPS proposed rule introduces Comprehensive APCs and more packaging that will impact you
On July 8, 2015, the Centers for Medicare & Medicaid Services (CMS) update included pr
Since the passage of the Affordable Care Act (ACA), CMS has been slowly making its transition awa
JULY 8, 2015
MACs recently selected more than 29,000 records for review as part of CMS’ probe audits of
CMS provides front-end updates for July On March 26, CMS released a change request t
CMS’ 2014 final rule clarified its position that categories of non-physician practitioners
  For the first time in some 20 years, CMS has updated its Conditions of Participati
FEBRUARY 1, 2017
 CMS releases proposed emergency preparedness requirements
The CMS last week announced the final list of hospitals that are receiving a 1% penalty for havin
DECEMBER 23, 2014
After CMS review, The Joint Commission has finally prepublished revisions to the Emergency Manage
CMS wants to replace the meaningful use program for physicians with a program that is "far s
The site-neutral payment provision in CMS’ 2017 OPPS proposed rule could level the playing
The 2015 OPPS proposed rule introduces Comprehensive APCs and more packaging that will impact you
A query by CMS officials questioning whether accrediting organizations (AO) that also offer consu
APRIL 1, 2019
After several requests, CMS finally issued a waiver for some—but not all—equipment in
JULY 25, 2020
Over the past 15 years, CMS has refined its understanding of and commitment to OPPS as a p
CMS finalizes Medicaid face to face rule CMS has issued a final rule re
by Josh Poltilove Three scenarios CMS officials walked agencies through during a
Extracorporeal photopheresis   On August 22, CMS relea
In the Medicare Claims Processing cms.gov/Regulations-and-Guidance/Guida
Be prepared to ask for time extensions from your accrediting organization and CMS to bring doors
OCTOBER 1, 2018
 Be prepared to ask for time extensions from your accrediting organization and CMS to bring
OCTOBER 1, 2018
by: Kirsten Dize CMS released the 2018 guidance manual for OASIS-C2 on August 4.
By Steven Andrews, Editor   CMS has finally released details
CMS must improve its physician outreach and beef up its IT systems to successfully implement the
CMS underpaid Medicare Advantage plans for the cost of treating patients with multiple chronic co
Q: Is there a way to convince management that Security Rule compliance is just as importa
Since January, providers have been struggling to reconcile conflicts between CMS' rules an
On July 13, 2015, the Centers for Medicare & Medicaid Services (CMS) announced a propo
CMS released an interim final rule on March 31 in an effort to ease restrictions for health care
CMS clarifies coverage of extracorporeal photopheresis  On August
by Josh Poltilove Agencies seeking to pass CMS’ Review Choice Demonstratio
Providers have one last chance to volunteer for ICD-10 end-to-end testing, with CMS extend
MAY 13, 2015
JUSTCODING
The American Hospital Association calls CMS’ proposed 2% reduction in outpatient payments &
CMS has proposed paying healthcare providers for the time they spend discussing end-of-life medic
JULY 14, 2015
CMS updates contractor instructions for enrollment and re-enrollment applications
CMS updates contractor instructions for enrollment and re-enrollment applications  
Excellent question, given the active season we’ve been having. You must comply with CMS&rsq
CMS aims to launch pilot prior authorization program in 5 states
You have one more chance to participate in CMS’ end-to-end testing. The agency is currently
There's a lot going on in CMS' proposed rule for year two of the quality payment program (QPP), s
MARCH 11, 2015
JUSTCODING
CMS has reversed its stance requiring Medicare Advantage (MA) plans to apply Medicare fee-for-ser
This Friday, CMS will accept final technical expert panel (TEP) cms.gov/Medic
by Kirsten Dize The OASIS-C2 Q&As that CMS posted February 24 finally offer di
CMS cms.gov/Medicare/Coding/ICD10/Downloads/2015-April-Testing-Results
CMS has released a cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/201
  CMS has released cms.gov/Outreach-and-Education/Outreach/NP
SEPTEMBER 9, 2015
JUSTCODING
CMS updates contractor instructions for enrollment and re-enrollment applications
When CMS releases rules, the length can be intimidating. But even at a relatively slim 700
CMS will not conduct post-payment patient status reviews for admis
As of today, CMS, The Joint Commission, and HFAP will be surveying hospitals to the 2012 Life Saf
NOVEMBER 1, 2016
On April 15, CMS posted a proposed rule in the Federal Register that would change the Medicare an
CMS recently released an cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Specia
DECEMBER 15, 2015
In the new proposed home health PPS rule, CMS states agencies providing a larger percentage of ov
CMS released cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ML
ICD-10 coding: What to expect On July 31, HHS issued a rule
OCTOBER 1, 2014
 CMS wants your thoughts on its 2017 OPPS proposed changes. In various places in the propose
Under the proposed rule hospitals would have to make their 'real, negotiated prices known to pat
AUGUST 1, 2019
On October 29, 2015, the Centers for Medicare & Medicaid Services (CMS) proposed to revise
OCTOBER 30, 2015
On February 1, 2018, CMS proposed new Medicare Advantage and Part D payment and policy updates to
CMS released 2016 OPPS proposed rule On July 1, CMS released CMS-1633-
In the final days of 2015, CMS released a draft of OASIS-C2. The document includes some minor cha
Compliance with the 2-midnight rule can be tricky for many organizations, which has left many cas
NOVEMBER 10, 2015
The FDA in December issued a final rule on the safety and effectiveness of active ingredients in
The Centers for Medicare & Medicaid Services (CMS) has issued guidance effective immediately
JUNE 10, 2014
On April 23, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a propose
APRIL 24, 2015
CMS proposes adding new comprehensive APCs (C-APC) in 2016, but did not change the logic o
On March 8th, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule t
MARCH 11, 2016
CMS offers five solutions to help address inadequate HIPAA Security Rule–requ
CMS announced it has extended its enforcement delay of the 2-midnight rule from September 30 to J
SEPTEMBER 1, 2015
On March 17, CMS announced a blanket 1135 Waiver to expand the use of telehealth, which provides
OPPS costs rose approximately $1 billion more than expected in 2014 due to a CMS overestim
Ensure compliance with CMS’ restraint guidelines! Use of re
MARCH 15, 2016
In the five months since CMS released its sepsis management bundle, a major change to the definit
APRIL 12, 2016
ICD-10 implementation is 27 days away. CMS completed its third and final ICD-10 end-to-end testin
Providers who want to volunteer to participate in CMS' final round of ICD-10 end-to-end testing h
An cms.gov/Medicare/Coding/ICD10/Downloads/ICD10NextStepsInfographic201603
  CMS recently updated the Medicare Claims Processing Manual, with changes
SEPTEMBER 17, 2014
JUSTCODING
CMS has released the final draft of its strategic vision plan for how healthcare professionals&rs
CMS officially declared October 1, 2015, the new ICD-10 implementation date with the publicatio
SEPTEMBER 17, 2014
JUSTCODING
New communication ruling for home health and hospices takes effect
  Providers who want to volunteer to participate in CMS' final round of ICD-10 end
MARCH 18, 2015
JUSTCODING
CMS cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3217CP.
MARCH 25, 2015
JUSTCODING
CMS today announced a new ICD-10 education and training-driven collaboration with the Amer
On Wednesday, CMS will host a special open door forum to solicit provider feedback on the
CMS last week proposed revisions that would add recognition of same-sex spouses to the Condition
On November 24, CMS announced that it will extend the time frame for providers to comment on the
The policies that CMS publishes each year in the OPPS proposed rule don't always come as a
Although CMS has issued blanket waivers, the vast majority of the Medicare requirements remain in
Last Wednesday, CMS re-enabled provider registration in the Individuals Authorized Access
Bilateral procedures may have been incorrectly paid On June 30, CMS released MLN
The controversy around Medicare's Recovery Audit Contractor program continues; a judge has ruled
SEPTEMBER 4, 2014
MAY 7, 2014
JUSTCODING
Because CMS has not created any national ED E/M guidelines, providers must create their ow
SEPTEMBER 30, 2015
JUSTCODING
CMS releases October 2015 quarterly update of HCPCS drug/biological code changes
CMS converting most MUEs to per-day edits On June 30, CMS released M
On July 2, CMS rescinded Transmittal 1481, dated March 27, 2015, and replaced it wi
Providers have until Monday, March 24, to sign up for CMS' ICD-10 end-to-end testing that will oc
The 2019 proposed PPS rule references this concern in several areas. CMS recognizes there are severa
CMS releases revised 2014 update for clinical laboratory fee schedule and laboratory se
The Centers for Medicare & Medicaid Services (CMS) is proposing new regulations that implemen
The National Association for Home Care & Hospice (NAHC) filed comments to CMS regarding the i
Last week, CMS issued a proposed rule to bundle hospital payments for services related to hip and
Waiting for the final rule? Here’s a checklist to prepare
CMS identifies obsolete shared systems reports On May 1, CMS released a change reque
by Josh Poltilove CMS feels it’s necessary to develop a comprehensive, sta
CMS posted a handful of notable updates in recent weeks related to hospice quality init
CMS recently released corrected versions of the second round of Quality of Patient Care Star Rati
CMS held a webinar on May 12 explaining the methodology and upcoming changes to its controversial
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule
APRIL 22, 2016
 New pass-through items in 2016 Q: Is CMS adding any items with pass-thr
CMS updates billing instructions for TMVR On April 24, CMS rescinded and replaced Trans
CMS issues revision of calendar year (CY) 2014 Annual Update for clinical laboratory fe
It appears many case managers still have a lot of questions when it comes to 2-midnight rule comp
NOVEMBER 3, 2015
Q: Can anyone tell me if CMS extended the RAP cancellation timeline due to the crisis? Ou
CMS releases 2016 proposed hospital OPPS rule On July 1, CMS released CM
Payment adjustment for FY 2014 extended On June 16, CMS pos
The OASIS-C2 Q&As that CMS posted Feb. 24 finally offer direction in writing on how to answer
CMS released the cms.gov/Medicare/Coding/ICD10/2015-ICD-10-PCS-and-GEMs.html"
This table, taken from the 2020 PPS proposed rule, includes the proposed, estimated 30-day, budge
Tomorrow is the final day for home health agencies and their counterparts in the skilled nursing,
Industry stakeholders seek clarity from CMS about draft interpretive guidelines.
CMS issues 2014 annual update for Clinical Laboratory Fee Schedule and Laboratory Servi
FY 2016 Medicare Part A SNF PPS pricer update On June 26, CMS released
As the final month for eligible hospice providers to participate in the Consumer Assessment of He
Our expert answers your questions about CMS’ newly adopted rule and what you need to know
FEBRUARY 16, 2017
CMS is proposing to remove one of the rating categories for the Home Health Quality Patient Star
Each year CMS revises its cms.gov/Outreach-and-Education/Medicare-Learning-N
JANUARY 30, 2018
On December 18, CMS published its cms.gov/Medicare/Quality-Initiatives-Patie
DECEMBER 29, 2015
CMS releases 2015 annual update for HPSA bonus payments  On Octobe
CMS has for several years expressed concerns that accrediting organizations (AO) have not been do
MAY 30, 2020
With the kickoff of ICD-10 just a handful of days away, CMS has
CMS has proposed a Medicare Prior Authorization of Home Health Services Demonstration pilot progr
When the Centers for Medicare & Medicaid Ser-vices’ (CMS) new Patient Driven Payment Mo
JANUARY 11, 2019
Last Monday, CMS posted a cms.gov/Regulations-and-Guidance/Legislation/Paper
by: Josh Poltilove Experts fear a lack of detailed surveyor training from CMS on
CMS updates Medicare Claims Processing Manual to provide language-only changes f
CMS issues National Coverage Determination (NCD) for single chamber and dual chamber permanent
I have some questions regarding the CMS Instruction for Medical Review on Home Health Ce
In the cms.gov/Medicare/Coding/OutpatientCodeEdit/Downloads/FinalSumof
CMS on Oct. 27 provided the National Association for Home Care & Hospice (NAHC) a draft versi
2-midnight rule draws concerns about emergency physician admitting privileges
After a CMS survey, the home health agency administrator, clinical manager, and any other key per
CMS recently updated its Clinical Laboratory Amendments (CLIA) for lab work at critical access ho
APRIL 12, 2016
  Actually, the news is even bigger than that: it appears that the CMS machine is
APRIL 17, 2014
April 1 was supposed to mark the final six months providers, payers, and CMS had to prepar
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JANUARY 20, 2015
MARCH 25, 2015
JUSTCODING
The introduction of the Home Health Groupings Model (HHGM) into the proposed rule means preparing
CMS releases National Coverage Determination for single and dual chamber permanent card
CMS provides front-end updates for July On March 26, CMS released a cha
With less than one month until implementation, CMS says it’s ready for ICD-10, and so are m
SEPTEMBER 8, 2015
Congress finally repealed the Sustainable Growth Rate (SGR) this month. The fix ends more than a
  By Steven Andrews   Congress finally repealed the S
NAHC submits recommendations to CMS regarding the hospice cost report
Surprise rule interpretation may force changes on some facilities In a rather surprisin
MARCH 9, 2017
In the IPPS Proposed Rule
MAY 7, 2014
JUSTCODING
On July 7, CMS posted a cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/20
In 2011, The Joint Commission ruled that physicians and practitioners were forbidden from using t
CMS designates certain procedures as inpatient-only, but identifies them using CPT codes (
MAY 7, 2014
JUSTCODING
CMS designates certain procedures as inpatient-only, but identifies them using CPT® co
MAY 21, 2014
JUSTCODING
CMS is preparing to cancel four mandatory episode payment models for common cardiac and orthopedi
Last Tuesday, CMS announced a forthcoming model to expand its accountable care organization (ACO)
CMS released an updated memo on April 24 to state surveyors reiterating previous guidance about h
CMS recently announced that the star rating methodology soon to augment Home Health Compare will
In our intermittently continuing series on the (final!) adoption of the 2012 Life Safety Code(r),
OCTOBER 27, 2016
Pressure ulcers got some attention in the PPS final rule, specifically related to payment for neg
To clarify and correct existing instructions On September 19, CMS relea
A reminder: CMS wants your feedback Kudos? Complaints? Questions
Most facilities know that CMS amended Title 42 of the
AUGUST 27, 2014
JUSTCODING
CMS' 2015 IPPS proposed rule, released April 30, focuses on quality measures, such as hosp
JUNE 18, 2014
JUSTCODING
  Proposed rules, OIG reports, and bundling, oh my!
SEPTEMBER 11, 2015
  Proposed Rule Q&A with Reginald Hislop III
OCTOBER 23, 2015
  Providers worry that proposed rule could cut Medicaid revenue
NOVEMBER 9, 2018
 by Debbie Mackaman, RHIA, CPCO, CCDS CMS released the 2017 OPPS proposed r
Know what your providers can message each other In January, CMS decided to clear up th
MARCH 1, 2018
CMS seeks comments on OASIS C2 CMS has opened the comment period
CMS held an open door forum (ODF) last Thursday to provide more details about a recently announce
CMS revises signature requirements On July 24, CMS released a change re
Homecare workers achieved a victory when the Department of Labor ruled they are entitled to overt
The Joint Commission recently approved the 2016 accreditation and certification decision rules fo
OCTOBER 6, 2015
In the 2015 OPPS proposed rule narrative text, CMS tells us it is proposing to conditional
Provider Reimbursement Manual update  On May 23, CMS released
CMS proposes changes for Accountable Care Organizations On December 8,
The cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/
JULY 8, 2015
JUSTCODING
CMS recently spoke with the provider community to help dispel some of the myths surroundi
CMS review has prompted waves of changes. Even more changes to The Joint Commission&rsq
APRIL 20, 2017
By A.J. Plunkett (aplunkett@decisionhealth.com) CMS wants The Joint Comm
DECEMBER 21, 2019
CMS proposes hospice changes for FY2017 CMS last week issued a proposed
by Josh Poltilove CMS’ plan to eliminate “Influenza im-munization rec
CMS updates Chapter 3 of the Program Integrity Manual (PIM)  
CMS addressed a question about whether agencies should discharge a patient when a home health pat
How will the CMS adoption of the 2012 editions of NFPA 101 and NFPA 99 affect you? 
AUGUST 31, 2017
CMS has contracted with an SMRC to lower improper payment rates
SEPTEMBER 1, 2014
Clarify the date-of-service rules you follow for reporting common services and you’ll overc
SEPTEMBER 18, 2017
A lot of people still have questions about the 2-midnight rule and may wonder if their chosen pra
OCTOBER 6, 2015
CMS has released a host of important updates for the hospice provider community in the past coupl
For the sixth year in a row, CMS and the AMA made no changes to CPT® coding or bil
FEBRUARY 10, 2015
http://www.medicarecompliancewatch.com/network-events/cms-events   Upcoming CMS e
http://www.medicarecompliancewatch.com/network-events/cms-events Upcoming CMS
http://www.medicarecompliancewatch.com/network-events/cms-events Upcoming CMS events
CMS to hold call on value-based purchasing The Centers for Medicare &
CMS is proposing to set payments for certain services performed by non-exempt off-campus provider
  Proposed Rule Q&A with Reginald Hislop III, Managing Partner and CEO of H2 Healthcare, LLC
SEPTEMBER 4, 2015
  Trump administration's proposed rule aims to penalize legal immigrants for using Medicaid
OCTOBER 12, 2018
by Kirsten Dize and Megan Herr The latest release of CMS’s quarterly OASIS
In early March, the Centers for Medicare and Medicaid Services (CMS) updated Appendix Q, Guidance
CMS designates a certain set of procedures as inpatient-only, meaning it will only reimburse faci
OCTOBER 8, 2014
JUSTCODING
  CMS HCPCS update files
NOVEMBER 6, 2015
  Upcoming CMS open door forums
AUGUST 31, 2018
ECRI: The rules on copying and pasting medical information In 2016, the
CMS released a new proposal to strengthen the Shared Savings Program for ACOs. The rule pr
DECEMBER 12, 2014
Stop scanning through endless rules and trying to interpret complex regulations—our top Med
In the wake of a CMS ruling that will make antibiotic stewardship
JUNE 28, 2016
There is no language specifically stating an NP or PA cannot give orders. Rather, the rules requi
The 126th State District Court in Austin, Texas, has ruled that Texas Medical Board (TMB) Rule 1
With HHS' recent release of its final rule,
The final report from the Alliance for Home Health Quality and Innovation (AHHQI)’s Fut
by Josh Poltilove CMS’ long-awaited draft version of the interpretive guidel
In a new memo to its state survey agencies, CMS said it would use Joint Commission ligature recom
OCTOBER 1, 2018
The turn of February brought with it the latest epistle from our friends at CMS as they continue
FEBRUARY 14, 2019
The release earlier this month of secret Medicare Advantage audits CMS conducted on several major
CMS revises ICD-10 codes CMS officially finalized the first majo
Last year, CMS updated key provisions of its medical staff Conditions of Participation. HCPro te
JUNE 18, 2015
Physician practices are working with a new set of rules when it comes to engaging patients online
After a long period of anticipation, it looks as though CMS will incorporate ligature risk recomm
NOVEMBER 1, 2018
Keeping up with education and training with The Joint Commission and CMS Editor
The Department of Labor (DOL) recently decided to appeal a ruling that effectively ended changes
Complicated rules surround hazardous waste disposal and healthcare facilities want to reduce volu
OCTOBER 15, 2015
CMS is taking action to reduce health disparities between U.S. patients. The plan
SEPTEMBER 22, 2015
CMS pilots focused surveys to assess dementia care, MDS accuracy
SEPTEMBER 1, 2014
CMS has launched the Virtual Research Data Center (VRDC) to meet the rising demand for timelier M
  CMS proposes major revision to regulations for long-term care
  CMS unveils bundled payments for joint replacements
NOVEMBER 6, 2015
  Notes from the CMS LTC/SNF Open Door Forum
APRIL 29, 2016
  CMS releases six new quality measures
  CMS allowing physicians to pick their pace of participation with Quality Payment Program
SEPTEMBER 9, 2016
  CMS Proposes Additional Bundled Payments: The Postacute Implications
SEPTEMBER 9, 2016
  The IMPACT Act in 2017- last chance to register for CMS event
FEBRUARY 24, 2017
  CMS delays the expansion of bundled payment programs
MARCH 24, 2017
  CMS seeks comment on RUG-IV replacement
  Technical experts needed for the CMS SNF QRP panel
  New CMS Quality Payment Program listserv available
  CMS to grant exceptions to providers affected by Hurricane Irma
SEPTEMBER 15, 2017
  CMS cancels two mandatory bundled-pay models
DECEMBER 8, 2017
  CMS proposes Medicare Advantage and Part D payment and policy updates
FEBRUARY 2, 2018
  New CMS policy could change inpatient rehab denial trend
  CMS releases 2019 Medicare Parts A&B premiums and deductibles
OCTOBER 19, 2018
  CMS publishes 2016 SNF PUF data
OCTOBER 12, 2018
  Civil monetary penalties to fund new CMS quality improvement initiative
NOVEMBER 30, 2018
  Submit your PDPM questions to CMS for December 11 call
NOVEMBER 30, 2018
Organizations often struggle to finalize charts after discharge so they can be coded in a timely
  For the sixth year in a row, CMS and the AMA made no changes to CPT®
FEBRUARY 4, 2015
JUSTCODING
An Iowa Board of Medicine administrative rule banning abortion through a teleconferencing system
The Illinois Supreme Court ruled that information collected under the Health Care Professional C
FEBRUARY 24, 2016
The Centers for Medicare & Medicaid Services (CMS) will soon launch a series of updates for
CMS recognizes the massive number of ultra-high therapy claims submitted by SNFs over the years
DECEMBER 9, 2016
Final-year medical residents reported being heavily recruited by hospitals, medical groups
JANUARY 15, 2015
CMS has released a new resource to help providers find the right contacts for ICD-10 questions in
OCTOBER 21, 2015
JUSTCODING
The presidential election of 2016 is finally behind us, but it has done little to clarify what&rs
SEPTEMBER 3, 2014
JUSTCODING