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Displaying records 1 to 20 out of 3262 results for "CMS".
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SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
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 HCPCS update files
NOVEMBER 6, 2015
LONG-TERM CARE DEPARTMENT
  Upcoming CMS open door forums
AUGUST 31, 2018
LONG-TERM CARE DEPARTMENT
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
LONG-TERM CARE DEPARTMENT
  Notes from the CMS LTC/SNF Open Door Forum
APRIL 29, 2016
LONG-TERM CARE DEPARTMENT
  CMS releases six new quality measures
  CMS allowing physicians to pick their pace of participation with Quality Payment Program
SEPTEMBER 9, 2016
LONG-TERM CARE DEPARTMENT
  CMS Proposes Additional Bundled Payments: The Postacute Implications
SEPTEMBER 9, 2016
LONG-TERM CARE DEPARTMENT
  New CMS rule contains changes to binding arbitration clauses
SEPTEMBER 30, 2016
LONG-TERM CARE DEPARTMENT
  CMS updates Conditions of Participation in Final Rule
NOVEMBER 4, 2016
LONG-TERM CARE DEPARTMENT
  CMS Finalizes the New Medicare Quality Payment Program
OCTOBER 28, 2016
LONG-TERM CARE DEPARTMENT
  CMS is updating the Medicare drug spending dashboard
DECEMBER 29, 2016
LONG-TERM CARE DEPARTMENT
  The IMPACT Act in 2017- last chance to register for CMS event
FEBRUARY 24, 2017
LONG-TERM CARE DEPARTMENT
  CMS delays the expansion of bundled payment programs
MARCH 24, 2017
LONG-TERM CARE DEPARTMENT
  Technical experts needed for the CMS SNF QRP panel
  New CMS Quality Payment Program listserv available
  CMS seeks comment on RUG-IV replacement
  CMS to grant exceptions to providers affected by Hurricane Irma
SEPTEMBER 15, 2017
LONG-TERM CARE DEPARTMENT
  CMS cancels two mandatory bundled-pay models
DECEMBER 8, 2017
LONG-TERM CARE DEPARTMENT
  CMS proposes Medicare Advantage and Part D payment and policy updates
FEBRUARY 2, 2018
LONG-TERM CARE DEPARTMENT
  New CMS policy could change inpatient rehab denial trend
  CMS now conducting on-site and off-site PBJ audits
MARCH 16, 2018
LONG-TERM CARE DEPARTMENT
  Billers instructed to review CMS updates to Medicare policy manuals
MARCH 23, 2018
LONG-TERM CARE DEPARTMENT
  CMS raises Medicare Advantage pay rates by 3.4% for 2019
  CMS publishes revised instructions for consolidated billing related to ambulance transportati
APRIL 20, 2018
LONG-TERM CARE DEPARTMENT
  ICD-10 FY2019 procedure codes and other CMS updates
  CMS issues guidance for handling insufficient documentation, ADRs
  CMS promises targeted Medicaid audits, stricter enforcement
  CMS seeks public comment on new proposed Medicare application process
  CMS to present an overview of the Medicare Secondary Payer Recovery Portal
AUGUST 3, 2018
LONG-TERM CARE DEPARTMENT
  CMS releases updates to billing for flu vaccine
SEPTEMBER 14, 2018
LONG-TERM CARE DEPARTMENT
  CMS seeks billing specialists to participate in provider compliance focus group
SEPTEMBER 28, 2018
LONG-TERM CARE DEPARTMENT
  CMS publishes 2016 SNF PUF data
OCTOBER 12, 2018
LONG-TERM CARE DEPARTMENT
  CMS releases 2019 Medicare Parts A&B premiums and deductibles
OCTOBER 19, 2018
LONG-TERM CARE DEPARTMENT
  Civil monetary penalties to fund new CMS quality improvement initiative
NOVEMBER 30, 2018
LONG-TERM CARE DEPARTMENT
  Submit your PDPM questions to CMS for December 11 call
NOVEMBER 30, 2018
LONG-TERM CARE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) will soon launch a series of updates for
CMS has released a new resource to help providers find the right contacts for ICD-10 questions in
OCTOBER 21, 2015
JUSTCODING
The Centers for Medicare & Medicaid Services (CMS) has issued an updated version of the Hospi
  In a cms.gov/Research-Statistics-Data-and-Systems/Monitoring
  CMS pushes SNFs toward payment reform in FY 2016 PPS final rule
SEPTEMBER 4, 2015
LONG-TERM CARE DEPARTMENT
  CMS' updated 60-day overpayment provision may cause practical implementation challenges
  CMS is rolling out the next version of Transforming Clinical Practice Initiative Support and
  Upcoming payment model advances CMS' Initiative to Reduce Avoidable Hospitalizations Among Nu
  CMS examines inappropriate guiding of people eligible for Medicare or Medicaid into Marketpla
AUGUST 19, 2016
LONG-TERM CARE DEPARTMENT
  CMS extends, expands fraud-fighting enrollment moratoria efforts in six states
AUGUST 5, 2016
LONG-TERM CARE DEPARTMENT
  In Focus: CMS announces demonstration saved $10 million second time around
  CMS launches three new policies, continuing the shift to value-based care
DECEMBER 22, 2016
LONG-TERM CARE DEPARTMENT
  CMS Issues Proposed Rule to Increase Patients' Health Insurance Choices for 2018
FEBRUARY 16, 2017
LONG-TERM CARE DEPARTMENT
  Transforming Health Care Delivery through the CMS Innovation Center: Better Care, Healthier P
MARCH 10, 2017
LONG-TERM CARE DEPARTMENT
  Antibiotic stewardship addressed head on in CMS’ revised infection control requirements
  CMS is hosting a live webcast for SNFs: How review and correct reports fit into quality repor
  RCS-1 CMS case-mix pre-rule: Get ready for big changes
  CMS using MEDCAC’s recommendations for health outcomes in the Medicare population
  CMS QPP proposal: Clinicians can mix reporting methods to get to six measures
JULY 21, 2017
RESIDENCY DEPARTMENT
  CMS Special Open Door Forum: The IMPACT Act and Improving Care Coordination
SEPTEMBER 8, 2017
LONG-TERM CARE DEPARTMENT
  Lawmakers estimate CMS mandate will cost providers $50,000 annually, letters submitted to del
OCTOBER 20, 2017
LONG-TERM CARE DEPARTMENT
  Lawmakers estimate CMS mandate will cost providers $50,000 annually, letters submitted to del
OCTOBER 27, 2017
LONG-TERM CARE DEPARTMENT
  CMS gives providers a peak into assessment protocols for data elements under IMPACT Act
DECEMBER 15, 2017
LONG-TERM CARE DEPARTMENT
  MedPAC comments on CMS’s proposed rule on Medicare Part C and Part D
JANUARY 5, 2018
LONG-TERM CARE DEPARTMENT
  CMS published additional instructions for processing updated Part B therapy claims
MARCH 30, 2018
LONG-TERM CARE DEPARTMENT
  CMS says this is number one reason for Medicare denials, publishes provider tips
MARCH 23, 2018
LONG-TERM CARE DEPARTMENT
  MedPAC advises CMS to establish payment equity between postacute care settings
APRIL 20, 2018
LONG-TERM CARE DEPARTMENT
  CMS reduces reimbursement by 13% for non-emergency BLS ambulance transports to and from renal
APRIL 20, 2018
LONG-TERM CARE DEPARTMENT
  CMS makes major revisions to RCS model, introduces new proposed Patient-Driven Payment Model
  CMS call to clarify qualified Medicare beneficiary (QMB) program billing requirements
  SNFs found to be out of compliance with QRP requirements will receive letter from CMS
  CMS Special Open Door Forum: The IMPACT Act and standardized patient assessment data elements
  10 things you need to know about CMS? final SNF PPS rule, and PDPM
AUGUST 31, 2018
LONG-TERM CARE DEPARTMENT
  CMS makes several Medicaid announcements, including new audits and requirement for budget neu
AUGUST 24, 2018
LONG-TERM CARE DEPARTMENT
  CMS administrator aims to make doctors' offices a "fax free zone" by 2020
AUGUST 17, 2018
LONG-TERM CARE DEPARTMENT
  CMS invites Medicare Part A providers to learn new Medicare Cost Report e-filing system
OCTOBER 5, 2018
LONG-TERM CARE DEPARTMENT
  CMS publishes corrections to RUG-IV federal per diem rates & MDS item in SNF PPS final rule
OCTOBER 5, 2018
LONG-TERM CARE DEPARTMENT
  CMS final rule makes changes to how physicians are paid, delays E/M coding reform
NOVEMBER 2, 2018
LONG-TERM CARE DEPARTMENT
CMS first added ratings in 2005 and in 2008, added the first five-star quality rating to nursing
APRIL 14, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
Centers for Medicare & Medicaid Services (CMS) Acting Principal Deputy Administrator P
The Centers for Medicare & Medicaid Services (CMS) has begun a three-year pilot project to i
JANUARY 8, 2016
LONG-TERM CARE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) and America’s Health Insurance Plans
FEBRUARY 19, 2016
LONG-TERM CARE DEPARTMENT
On May 3, 2016, the Centers for Medicare & Medicaid Services (CMS) announced a final rule (
CMS is currently soliciting nominations for technical expert panel members for quality measures
AUGUST 12, 2016
LONG-TERM CARE DEPARTMENT
Some pressure ulcer data was mistakenly excluded from recent CMS reports on quality measures for
CMS has released a new resource to help providers find the right contacts for ICD-10 questions in
NOVEMBER 17, 2015
PHYSICIAN PRACTICE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) is proposing to expand for HIV scre
FEBRUARY 6, 2015
LONG-TERM CARE DEPARTMENT
Last Friday, CMS posted the annual update for the 2014 electronic clinic quality measures (eCQM)
When CMS shared the findings of the 2015 Physician Quality Reporting System (PQRS), it also publi
While you may not be ready for ICD-10, CMS says testing now shows its system is well equipped for
SEPTEMBER 15, 2015
CASE MANAGEMENT DEPARTMENT
1:00–2:30 p.m. ET, Wednesday, February 24, 2016 As CMS increases the frequ
FEBRUARY 18, 2016
NURSING DEPARTMENT
On December 18, 2015, CMS posted the draft Quality Measure Development Plan, a strategic framewo
The Centers for Medicare & Medicaid Services (CMS) has announced that the pre-claim review de
Based upon a data analysis, CMS concluded that on average the first 30 days of an episode were mo
CMS is hosting an open door forum 2 p.m. to 3 p.m. EST Oct. 10 to discuss modifications and propo
Over the past 15 years, CMS has refined its understanding of and commitment to OPPS as a p
  cms.gov/2015/01/29/cms-intends-to-modify-requirements-for-m
CMS released the cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Ins
A provision in CMS’ new rule to modify or eliminate unnecessary regulations will ease requ
On November 3, 2015, the Centers for Medicare & Medicaid Services (CMS) released an interac
NOVEMBER 6, 2015
LONG-TERM CARE DEPARTMENT
CMS and ONC are seeking comments from providers and vendors on several health IT certification is
CMS is adequately preparing to implement ICD-10 October 1, according to a
FEBRUARY 24, 2015
PHYSICIAN PRACTICE DEPARTMENT
By Steven Andrews   The latest guidance from CMS on modifier
By A.J. Plunkett (aplunkett@decisionhealth.com) As of January 1, CMS eliminated th
JANUARY 23, 2019
SAFETY DEPARTMENT
Although CMS has issued blanket waivers, the vast majority of the Medicare requirements remain in
Since January, providers have been struggling to reconcile conflicts between CMS' rules an
CMS made relatively few changes in the April quarterly I/OCE update, introducing four new
CMS refined and updated its Comprehensive APC policy in the 2015 OPPS proposed rule releas
  To help reduce the number of appeals over short-term inpatient stay claims, CMS
SEPTEMBER 4, 2014
MEDICAL STAFF DEPARTMENT
The CMS last week rolled out a new star rating system on
APRIL 21, 2015
ACCREDITATION DEPARTMENT
Centers for Medicare & Medicaid Services (CMS) announces through its acting administra
Q: What are the new therapy reassessment requirements that CMS solidified in its
On July 13, 2015, the Centers for Medicare & Medicaid Services (CMS) announced a propo
Four major healthcare organizations asked CMS to postpone implementation of the severe sepsis and
SEPTEMBER 2, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
On September 21, 2015, the Centers for Medicare & Medicaid Services (CMS) announced
SEPTEMBER 25, 2015
LONG-TERM CARE DEPARTMENT
What are the CMS and Joint Commission hot spots for 2016? Join Bud Pate, REHS, and Lisa Eddy, RN,
NOVEMBER 4, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule this week that would
APRIL 21, 2016
MEDICAL STAFF DEPARTMENT
cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArtic
CMS has released Q&As in writing on its Home Health Quality Reporting Training website.
CMS has updated pages of the Hospice Item Set Manual V2.00 as a result of the federal Medicare ag
  CMS Administrator Marilyn Tavenner confirmed last week at the Healthcare Informa
MARCH 5, 2014
JUSTCODING
On February 25, CMS released a fact sheet regarding the transition to ICD-10. It states CMS is wo
CMS cms.gov/Medicare/Coding/ICD10/Downloads/2015-April-Testing-Results
Looking to help patients find the best home health agency? Direct them to the new CMS tool, Home
AUGUST 11, 2015
CASE MANAGEMENT DEPARTMENT
CMS is considering waiving the three-day hospital stay rule, required before a patient can be re
JANUARY 29, 2016
LONG-TERM CARE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017
The Centers for Medicare & Medicaid Services (CMS) today issued final regulations for the Med
In 2012, CMS established the Hospital Outpatient Payment Panel as an independent review en
On October 31st, 2014 CMS released Survey and Certification Memo 15-06-NH announcing the e
NOVEMBER 7, 2014
LONG-TERM CARE DEPARTMENT
On Friday, December 19, CMS announced that it is still reviewing the many applications it has rec
  CMS has reopened the submission period with a deadline of November 1 for hospita
OCTOBER 9, 2014
MEDICAL STAFF DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) released final Medicare Advantage (MA) and
APRIL 17, 2015
LONG-TERM CARE DEPARTMENT
On April 16, 2015, the Centers for Medicare & Medicaid Services (CMS) introduced star
APRIL 17, 2015
LONG-TERM CARE DEPARTMENT
CMS is adequately preparing to implement ICD-10 October 1, according to a
FEBRUARY 11, 2015
JUSTCODING
Last week, CMS released a revised version of the hospice item set (HIS) manual.
  On Thursday, CMS released a final rule updating the Medicare Shared Savings Prog
Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum on
OCTOBER 9, 2015
LONG-TERM CARE DEPARTMENT
CMS added three new questions on meaningful use requirements to their FAQ website. The new FAQs c
NOVEMBER 17, 2015
PHYSICIAN PRACTICE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) have shared the revised survey tools used
DECEMBER 11, 2015
LONG-TERM CARE DEPARTMENT
The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for:
Updates to the Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announ
AUGUST 19, 2016
LONG-TERM CARE DEPARTMENT
On August 18, 2016, The Centers for Medicare & Medicaid Services (CMS) issued a request for
AUGUST 19, 2016
LONG-TERM CARE DEPARTMENT
On August 10, 2016, the Centers for Medicare & Medicaid Services (CMS) updated the popular N
AUGUST 12, 2016
LONG-TERM CARE DEPARTMENT
CMS released cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/ML
The Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI)
The National Association for Home Care & Hospice (NAHC) has contacted CMS regarding claims th
CMS has approved the 2018 standards set forth by the home health accrediting body Community Healt
CMS outlined how to access updates to ICD-10 Local Coverage Determinations (LCDs) in its M
JUNE 25, 2014
JUSTCODING
CMS has offered some clarity on what it considers to be a “family of codes” in ICD-10
 CMS wants your thoughts on its 2017 OPPS proposed changes. In various places in the propose
CMS promised in May that a new ICD-10 implementation date would be revealed in the "n
CMS reintroduced Comprehensive APCs for device-dependent APCs with additional refinements
CMS and Medicare Administrative Contractors (MAC) are aware of certain issues regarding Nationa
NOVEMBER 25, 2015
JUSTCODING
Hospitals may find themselves directly in the line of fire as CMS ramps up its oversight of The J
DECEMBER 1, 2018
SAFETY DEPARTMENT
Hospitals may find themselves directly in the line of fire as CMS ramps up its oversight of The J
DECEMBER 1, 2018
SAFETY DEPARTMENT
CMS releases overview of Physician Feedback and Value-Based Modifier Programs On Feb
by Josh Poltilove Use CMS’ new GG self-care and mobility activity decision
CMS issues changes regarding Defense of Marriage Act and ICD-10 On Oct
by Josh Poltilove and Kirsten Dize CMS is conducting data analysis to prepare fo
By A.J. Plunkett (aplunkett@decisionhealth.com) Expect CMS to continue i
NOVEMBER 10, 2019
SAFETY DEPARTMENT
In exchange for dropping appeals, CMS says it will provide partial payment of previously d
CMS recently cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-
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
In an effort to give consumers more information to make healthcare decisions, CMS published Medic
OPPS costs rose approximately $1 billion more than expected in 2014 due to a CMS overestim
Q: CMS released guidance this summer about not auditing or counting errors for the specif
A: CMS is not going to resurrect or reinstate the device-to-procedure edits for all
CMS and America’s Health Insuranc
FEBRUARY 17, 2016
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
CMS pushed back the deadline for physicians to enroll to prescribe Medicare Part D drugs. Physici
Ensure compliance with CMS’ restraint guidelines! Use of re
MARCH 15, 2016
ACCREDITATION DEPARTMENT
In the five months since CMS released its sepsis management bundle, a major change to the definit
APRIL 12, 2016
ACCREDITATION DEPARTMENT
Now that the CMS has adopted the 2012 Life Safety Code (LSC), safety experts are looking
AUGUST 31, 2016
SAFETY DEPARTMENT
RAPs will continue to be available under the HHGM in 2019. But CMS believes—based upon data
by: Josh Poltilove CMS has recently announced that the location search field on Ho
CMS filed a notice and request for comment on proposed revisions to the OASIS item set. T
In a cms-four-hospital-accreditation-entit
MARCH 20, 2018
ACCREDITATION DEPARTMENT
After much anticipation, CMS approved last year its own emergency preparedness rules separate fro
JUNE 7, 2018
SAFETY DEPARTMENT
On Wednesday, CMS will host a special open door forum to solicit provider feedback on the
The latest guidance from CMS on modifier -59 (distinct procedural service)
FEBRUARY 24, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS missed the mark in its recent CMS-ONC-request-
Expect CMS surveyors to be referring to recommendations set out by The Joint Commission last fall
AUGUST 7, 2018
ACCREDITATION DEPARTMENT
 Expect CMS surveyors to be referring to recommendations set out by The Joint Commission las
AUGUST 10, 2018
SAFETY DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) has announced the 2014 Part B premiu
NOVEMBER 22, 2013
LONG-TERM CARE DEPARTMENT
The CMS last week issued a rule designed to save $660 million annually and $3.2 billion over five
CMS yesterday announced a proposed rule on the adoption of the 2012 editions of the Life Safet
APRIL 15, 2014
ACCREDITATION DEPARTMENT
As part of the changes in its recent final rule, CMS has eliminated the requirement that ambulat
CMS recently added HCPCS code C2644 (brachytherapy source, cesium-131 chloride solution, p
CMS Administrator Marilyn Tavenner issued cms.gov/Newsroom/MediaReleaseDatabase/P
SEPTEMBER 4, 2014
LONG-TERM CARE DEPARTMENT
  Two CMS programs benefitting small rural hospitals have been extended through th
JUNE 19, 2014
MEDICAL STAFF DEPARTMENT
In December 2014, CMS posted a document on its Advisory Panel on Hospital Outpatient Payme
On April 16, CMS posted a proposed decision memorandum stating evidence is sufficient to add Huma
As part of the April quarterly OPPS update, CMS added two new modifiers valid April 1:
CMS announced this week it is making changes to the ICD-10 implementation transition period to h
To help reduce adverse events and readmissions, a rule proposed by CMS and published this week wo
NOVEMBER 3, 2015
ACCREDITATION DEPARTMENT
CMS issued a revision of the October 2015 I/OCE update that included changes for HCPCS code Q51
CMS recently released cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Special
DECEMBER 9, 2015
JUSTCODING
CMS finalized its proposal to reduce the conversion factor by 2% to account for its overestimat
On April 27, the Centers for Medicare & Medicaid Services (CMS) added six new quality measur
APRIL 29, 2016
LONG-TERM CARE DEPARTMENT
On June 7, the OIG posted a report stating it reviewed CMS’ administration of the Pioneer A
CMS approved a new specialty designation code that will help the agency distinguish between diffe
DECEMBER 13, 2016
PHYSICIAN PRACTICE DEPARTMENT
Home health agencies can now view the Home Health PPS PC Pricer for the 2017 calendar year. CMS p
According to CMS’ final rule, 35 OASIS items would be deleted or modified for 2019. NAHC be
CMS has decided to wait a year from Jan. 13 before imposing civil monetary penalties involving th
Both organizations have changed their expectations on the defintion of a hospital. CMS’s ne
DECEMBER 12, 2017
ACCREDITATION DEPARTMENT
CMS has issued new guidance that explains how agencies can go about converting subunits to branc
CMS has sent a memo to state survey agency directors about the new tags surveyors should use to s
  cms.gov/Medicare/Coding/ICD10/Downloads/PartialCodeFreeze.
MAY 30, 2014
SAFETY DEPARTMENT
By Steven Andrews, Editor   CMS has finally released details
Providers who want to volunteer to participate in CMS' final round of ICD-10 end-to-end testing h
Last Friday, CMS cms.gov/Research-Statistics-Data-and-Systems/Monitori
An cms.gov/Medicare/Coding/ICD10/Downloads/ICD10NextStepsInfographic201603
CMS must improve its physician outreach and beef up its IT systems to successfully implement the
It’s finally here. CMS’ new Emergency Preparedness rule goes into effect on W
NOVEMBER 14, 2017
ACCREDITATION DEPARTMENT
by A.J. Plunkett (aplunkett@decisionhealth.com) CMS announced in 2019 th
FEBRUARY 25, 2021
SAFETY DEPARTMENT
CMS details changes to reimbursement manual On September 19, CMS releas
CMS posted updated versions of all the guidance documents posted on the cms.g
MARCH 26, 2014
JUSTCODING
On January 23, CMS released cms.gov/Outreach-and-Education/Medicare-Learn
Last Wednesday, CMS re-enabled provider registration in the Individuals Authorized Access
CMS is calling the completion of their second ICD-10 end-to-end testing week a success. F
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
Expect CMS to continue to put pressure on The Joint Commission (TJC) and other accrediting organi
OCTOBER 9, 2018
ACCREDITATION DEPARTMENT
CMS updates billing instructions for TMVR  On April 24, CMS rescin
BY A.J. PLUNKETT (APLUNKETT@H3.GROUP) Expect CMS to continue pressuring
DECEMBER 1, 2018
ACCREDITATION DEPARTMENT
CMS releases overview of Physician Feedback and Value-Based Modifier Programs
CMS accepted an average of 89% of ICD-10 claims submitted during the national front-end te
JUNE 4, 2014
JUSTCODING
The July quarterly I/OCE update from CMS brought few new APCs or edit updates, but did del
CMS and its contractors will conduct three ICD-10-CM/PCS testing periods in November, March, and
CMS has included several proposals in the
CMS is currently looking for 850 volunteers from various specialties and sizes for the Jan
CMS has released a proposal to strengthen the Shared Savings Program for Accountable Care Organiz
On November 24, CMS announced that it will extend the time frame for providers to comment on the
CMS clarified changes to the Medicare Program Integrity Manual that alter the timeframe fo
CMS is currently looking for 850 volunteers from various specialties and sizes for the January 26
Q: Did CMS grant pass-through status for any new devices in April? 
A revamped version of the CMS Partnership for Patients program will launch with an improved track
FEBRUARY 17, 2015
ACCREDITATION DEPARTMENT
Several years ago, CMS defined a list of nonsurgical extended duration therapeutic service
A change CMS made cms.gov/Medicare/Coding/OutpatientCodeEdit/OCEQtrRel
CMS will cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Provider-Par
CMS recently released an ICD-10 quick start cms.gov/Medicare/Coding/ICD10/Dow
CMS announced acms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets
JULY 15, 2015
JUSTCODING
The American Hospital Association calls CMS’ proposed 2% reduction in outpatient payments &
CMS updated their FAQs with two new questions for EHR Meaningful Use. The new FAQs explain meanin
The Centers of Medicare & Medicaid Services (CMS) has released a new public data set, the Hom
CMS finalized its proposals regarding the 2-midnight rule, including moving responsibility for ru
CMS wants to replace the meaningful use program for physicians with a program that is "far s
CMS may consider delaying implementation of the Medicare Access and CHIP Reauthorization Act (MAC
CMS’ grace period for reporting families of ICD-10-CM codes is coming to a close. Physician
SEPTEMBER 6, 2016
PHYSICIAN PRACTICE DEPARTMENT
On April 14, CMS sent out a memo with big proposals for accreditation. If passed, the proposed ru
APRIL 18, 2017
ACCREDITATION DEPARTMENT
A proposed rule (CMS-5524-P) released by CMS on August 15, 2017 would make the Comprehensive Care
Agencies can breathe a deep sigh of relief. CMS won’t launch its drastically revised home h
In response to CMS’ final emergency preparedness rule issued earlier this month,
DECEMBER 1, 2017
ACCREDITATION DEPARTMENT
On February 1, 2018, CMS proposed new Medicare Advantage and Part D payment and policy updates to
by Josh Poltilove CMS feels it’s necessary to develop a comprehensive, sta
CMS announces final regulatory changes affecting Medicare Parts C and D
AUGUST 1, 2014
LONG-TERM CARE DEPARTMENT
  Providers who want to volunteer to participate in CMS' final round of ICD-10 end
MARCH 18, 2015
JUSTCODING
Last week, CMS issued a proposed rule to bundle hospital payments for services related to hip and
CMS releases October 2015 I/OCE specifications On August 14, CMS releas
Q: CMS released guidance this summer about not auditing or counting errors for the specifi
CMS cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items
NOVEMBER 4, 2015
JUSTCODING
CMS and representatives of the private insurance industry have agreed to use a single set of heal
With spending on inpatient hospital services expected to increase by $746 million next year, CMS
AUGUST 9, 2016
ACCREDITATION DEPARTMENT
CMS launches new physician engagement imitative On October 13, CMS announced a push to im
OCTOBER 18, 2016
ACCREDITATION DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) have released new home health Conditions o
Effective 04/01/2014, Medicare stopped accepting paper claims on the old CMS 1500 claim fo
CMS releases July update to Medicare Physician Fee Schedule database 
Q: Has CMS released further guidance on billing lab tests under the OPPS for separate paymen
The CMS will make data on eight hospital-acquired conditions available on its website, a year aft
SEPTEMBER 9, 2014
ACCREDITATION DEPARTMENT
  Due to maintenance, CMS shut down its Open Payments database on Saturday, August
SEPTEMBER 4, 2014
MEDICAL STAFF DEPARTMENT
The Centers for Medicare and Medicaid (CMS) has fined 12 Medicare Advantage plans nearly $4 milli
APRIL 21, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
CMS recently cms.gov/Research-Statistics-Data-and-Systems/Monitoring-P
Since the passage of the Affordable Care Act (ACA), CMS has been slowly making its transition awa
JULY 8, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
Last week, CMS and the Core Quality Measures Collaborative (CQMC) made a huge announcement with t
FEBRUARY 23, 2016
ACCREDITATION DEPARTMENT
CMS last week announced plans to move forward with its prior authorizat
This week, the Centers for Medicare & Medicaid Services (CMS) issues Transmittal 3591. It p
The Centers for Medicare & Medicaid Services (CMS) announced a six-month extension of a state
After CMS review, The Joint Commission has finally prepublished revisions to the Emergency Manage
CMS updates Medicare Claims Processing Manual to provide language-only changes f
CMS issues changes regarding Defense of Marriage Act and ICD-10 On Oct
by: Josh Poltilove During a Feb. 28 open door forum, CMS provided details about ho
CMS refined and updated its Comprehensive APC policy in the
SEPTEMBER 3, 2014
JUSTCODING
CMS releases October 2015 quarterly update of HCPCS drug/biological code changes
CMS updates National Coverage Determination Manual for speech generating devices
Citing “stakeholder concerns,” the Centers for Medicare & Medicaid Services (CMS)
SEPTEMBER 1, 2018
ACCREDITATION DEPARTMENT
CMS proposed a new HCPCS modifier be appended to every code for a service furnished in a h
FEBRUARY 4, 2015
JUSTCODING
The CMS began its restructuring of the quality improvement organization (QIO) program with change
The Centers for Medicare & Medicaid Services (CMS) has issued guidance effective immediately
JUNE 10, 2014
ACCREDITATION DEPARTMENT
CMS posts July update to Medicare Physician Fee Schedule Database On June 6, CMS rel
Today, the Centers for Medicare & Medicaid Services (CMS) announced two initiatives to
OCTOBER 9, 2014
LONG-TERM CARE DEPARTMENT
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
  The American Medical Association (AMA) has asked CMS to postpone the deadline fo
AUGUST 21, 2014
MEDICAL STAFF DEPARTMENT
On April 23, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a propose
APRIL 24, 2015
LONG-TERM CARE DEPARTMENT
According to the Federal Register, CMS is proposing a rule that would update the payment rates us
APRIL 24, 2015
LONG-TERM CARE DEPARTMENT
The American Hospital Association (AHA) asked CMS to include potential payment solutions for shor
According to a press release issued on Feb 20, 2015 by CMS, there are proposed changes for
FEBRUARY 27, 2015
LONG-TERM CARE DEPARTMENT
CMS may not be getting it right when it comes to readmissions, according to a new study published
CMS has proposed paying healthcare providers for the time they spend discussing end-of-life medic
JULY 14, 2015
ACCREDITATION DEPARTMENT
Earlier in July, CMS sent a letter out to Medicare providers. The letter was sent as a rem
CMS announced its ICD-10 Coordination and Maintenance Committee Meeting to take place on Septembe
CMS announced on September 2, 2015, that they will grant awards totaling $67 million to support o
SEPTEMBER 4, 2015
LONG-TERM CARE DEPARTMENT
On October 6, 2015, the Centers for Medicare & Medicaid Services (CMS) and Office of t
OCTOBER 9, 2015
LONG-TERM CARE DEPARTMENT
On October 2, CMS released a change request to allow contractors to accept initials instead of si
What are the CMS and Joint Commission hot spots for 2016? Join Bud Pate, REHS, and Lisa Eddy, RN,
NOVEMBER 3, 2015
ACCREDITATION DEPARTMENT
On October 9, 2015, CMS posted Transmittal 149 to provide clarification to all providers
On December 18, CMS published its cms.gov/Medicare/Quality-Initiatives-Patie
DECEMBER 29, 2015
PHYSICIAN PRACTICE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) has released new "G" codes that
On March 8th, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule t
MARCH 11, 2016
LONG-TERM CARE DEPARTMENT
On March 9th, the Centers for Medicare & Medicaid Services (CMS) released a public data set t
MARCH 18, 2016
LONG-TERM CARE DEPARTMENT
On April 14, 2016, the Centers for Medicare & Medicaid Services (CMS)  announced its la
APRIL 15, 2016
LONG-TERM CARE DEPARTMENT
The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for
APRIL 29, 2016
LONG-TERM CARE DEPARTMENT
The National Association for Home Care & Hospice (NAHC) has raised concerns regarding CMS&rsq
CMS is creating a centralized database to help eligible professionals (EP) meet meaningful use re
On December 8, The Centers for Medicare & Medicaid Services (CMS) hosted a special open door
CMS aims to develop and implement two Transfer of Health (TOH) Information and Care Preferences q
The Centers for Medicare & Medicaid Services (CMS) announced on a January 19 call that they a
CMS has finalized its plan to cancel four mandatory episode payment models for common cardiac and
CMS has once again extended its moratoria on new home health agencies and new branches of existin
by Josh Poltilove The four pages of changes CMS has just made to its OASIS-D gui
Is it likely CMS will make any adjustments to the list of acceptable primary diagnosis co
As CMS focuses surveys on infection control in SNFs, it’s important for SNFs to make sure t
By Steven Andrews, Editor   CMS is introducing four new HCPCS
To clarify and correct existing instructions On September 19, CMS relea
Last week, CMS proposed a new rule intended to boost the success of Accountable Care Organiz
CMS finalized changes to multiple quality measures in the cms.gov/Medicare
  By Steven Andrews   CMS announced this week an expe
CMS is expanding the information available on its
DECEMBER 15, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS has to explain its calculation for a negative 0.2% reduction in inpatient payment rates as a
CMS releases advanced care planning fact sheet The Centers for M
by A.J. Plunkett (aplunkett@decisionhealth.com) CMS announced it is comb
MARCH 20, 2020
SAFETY DEPARTMENT
by A.J. Plunkett (aplunkett@decisionhealth.com) CMS announced it is comb
MARCH 26, 2020
SAFETY DEPARTMENT
Q: Can anyone tell me if CMS extended the RAP cancellation timeline due to the crisis? Ou
CMS updates interest rate for Medicare overpayments and underpayment 
You have one more chance to participate in CMS’ end-to-end testing. The agency is currently
OCTOBER 7, 2015
JUSTCODING
The idea behind CMS’ Comprehensive Care for Joint Replacement model is that payments for
The Centers for Medicare & Medicaid Services (CMS) has issued a cms.gov/
On May 12, 2016, CMS posted the third annual release of the Physician and Other Supplier Utiliza
On September 1, CMS published MLN Matters 10235 to supplement CMS Medicare Claims Processing Tran
SEPTEMBER 18, 2017
PHYSICIAN PRACTICE DEPARTMENT
On September 1, CMS published MLN Matters 9815 to supplement CMS Medicare Financial Management Tr
SEPTEMBER 18, 2017
PHYSICIAN PRACTICE DEPARTMENT
CMS is clearing up recent confusion on what medical providers can text each other. The agency con
JANUARY 2, 2018
ACCREDITATION DEPARTMENT
by Josh Poltilove In the short term, a new MLN Matters article announcing CMS wi
CMS issues National Coverage Determination (NCD) for single chamber and dual chamber permanent
CMS updates billing instructions for TMVR On April 24, CMS rescinded and replaced Trans
In August, the Centers for Medicare & Medicaid Services (CMS)
NOVEMBER 22, 2013
LONG-TERM CARE DEPARTMENT
Q: Did CMS issue any new HCPCS codes for drugs and biologicals for April 2014?
We won’t need to learn any new ICD-10-PCS codes or guidelines for 2015. CMS released the d
CMS released its second in a series o
AUGUST 20, 2014
JUSTCODING
The July quarterly I/OCE update from CMS brought few new APCs or edit updates, but did del
CMS releases fourth version of related claims transmittal On September
In 2014, CMS added skin substitutes to the list of packaged drugs and biologicals, dividin
  CMS added one modifier for 2015, but will not require its use until January 1, 2
According to a cms.gov/medicare-coverage-database/details/nca-decision-memo.a
FEBRUARY 20, 2015
LONG-TERM CARE DEPARTMENT
On April 15, CMS posted a proposed rule in the Federal Register that would change the Medicare an
When CMS introduced the -X{EPSU} modifiers in August 2014 to be used in specific instances
CMS released updated I/OCE specifications in January with several changes that could requi
Earlier this month, CMS cms.gov/Regulations-and-Guidance/Guidance/Transmittal
  CMS continues expand its ICD-10 Clinical Concepts Series for specialties on
AUGUST 26, 2015
JUSTCODING
CMS releases 2015–16 influenza resources for healthcare professionals
CMS notes that as comprehensive APC (C-APC) policies expand, the agency needs a way to ide
CMS recently released an cms.gov/Medicare/Coding/ICD10/Downloads/ICD10Specia
DECEMBER 15, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS has issued a draft of the Outcome and Assessment Information Set (OASIS)-C2, aiming to standa
A bill that allows CMS to expedite physicians’ applications for a meaningful use hardship e
DECEMBER 29, 2015
PHYSICIAN PRACTICE DEPARTMENT
The 2016 OPPS final rule includes the first negative payment update for the system, but CMS also
CMS followed through with its proposal to restructure APCs for nine clinical families in the 20
CMS underpaid Medicare Advantage plans for the cost of treating patients with multiple chronic co
The Centers for Medicare & Medicaid Services (CMS) has issues a Change Request (CR) 9497. The
Q: In regards to the new CMS requirements regarding corridor projections, will alcohol-based hand
OCTOBER 20, 2016
SAFETY DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) posted a series of Frequently Asked Questi
The National Association for Home Care & Hospice (NAHC) filed comments to CMS regarding the i
It’s finally here. CMS’ new Emergency Preparedness rule goes into effect on W
NOVEMBER 16, 2017
SAFETY DEPARTMENT
A new CMS memo creates a definition of a ligature risk, a time frame for correcting them, and int
DECEMBER 19, 2017
ACCREDITATION DEPARTMENT
Expect CMS to continue to put pressure on The Joint Commission (TJC) and other accrediting organi
DECEMBER 1, 2018
SAFETY DEPARTMENT
Expect CMS to continue to put pressure on The Joint Commission (TJC) and other accrediting organi
DECEMBER 1, 2018
SAFETY DEPARTMENT
Bilateral procedures may have been incorrectly paid On June 30, CMS released MLN
CMS updates influenza vaccine payment allowance  On September 3, C
CMS posts final decision on HIV screening   On April 13, CMS posted a final dec
CMS updates Program Integrity Manual On May 2, CMS released a change re
April 2014 update of the OPPS On February 28, CMS issued a recurring update
CMS extends coverage of aprepitant for chemotherapy-induced emesis 
By Steven Andrews, Editor   One of CMS' proposals in the
Cardiac rehabilitation programs for chronic heart failure On August 29, CMS rescinde
Last Monday, CMS posted a cms.gov/Regulations-and-Guidance/Legislation/Paper
CMS offered some clarity on what it considers to be a family of codes in ICD-10-CM.
CMS posts final decision on HIV screening   On April 13, CMS poste
Hospitals have 60 days to fix ligature risks In December, CMS unveiled a new definition
APRIL 1, 2018
ACCREDITATION DEPARTMENT
CMS provides front-end updates for July On March 26, CMS released a cha
CMS releases revised 2014 update for clinical laboratory fee schedule and laboratory se
CMS provides examples of claims that are related On August 8, CMS released a change
  CMS recently updated the Medicare Claims Processing Manual, with changes
SEPTEMBER 17, 2014
JUSTCODING
By Steven Andrews   CMS has completed another round of succes
CMS extended the deadline for hospitals and EPs to attest 2015 meaningful use data to
FEBRUARY 23, 2016
PHYSICIAN PRACTICE DEPARTMENT
This April, CMS sent out a memo with big proposals for accrediting organizations (AO). If passed,
JULY 11, 2017
ACCREDITATION DEPARTMENT
CMS issues change request for lumbar decompression coverage On May 16,
CMS updates CERT treatment of power mobility devices and ambulance transport claims
CMS extends coverage for aprepitant for chemotherapy-induced emesis On
CMS converting most MUEs to per-day edits On June 30, CMS released M
Expect CMS surveyors to be referring to recommendations set out by The Joint Commission (TJC) las
SEPTEMBER 1, 2018
SAFETY DEPARTMENT
Claims that are related   On August 8, CMS released a
CMS clarifies treatment of extracorporeal photopheresis  On August
CMS releases April 2015 I/OCE specifications On March 13, CMS released a notification to p
HOP Panel summer meeting scheduled CMS announced the summer meeting of
CMS revises coverage of cardiac rehabilitation programs On August 29, C
CMS updates implementation date for laboratory travel allowance fee 
CMS posted a handful of notable updates in recent weeks related to hospice quality init
The Centers for Medicare & Medicaid Services (CMS) is proposing new regulations that implemen
CMS issued the fiscal year (FY) 2017 IPPS proposed rule yesterday with updates to several quali
Extracorporeal photopheresis   On August 22, CMS relea
CMS provides front-end updates for July On March 26, CMS released a change request t
CMS will not conduct post-payment patient status reviews for admis
Q: Did CMS make any changes to the packaging of skin substitutes in the lates
  CMS is introducing four new HCPCS modifiers to specifically define subsets of mo
SEPTEMBER 3, 2014
JUSTCODING
For the last several years, CMS has updated the payment rates for separately payable drugs
CMS cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3217CP.
MARCH 25, 2015
JUSTCODING
CMS issues correction to the April 2015 update to the Medicare Physician Fee Schedule D
CMS recently released corrected versions of the second round of Quality of Patient Care Star Rati
  Q: What happened to modifier –JF (compounded drug)? CMS added it in Apr
Providers know the drill for addressing and operationalizing CMS' annual IPPS and OPPS updates,
CMS needs to evaluate, clarify, and modify sections of the Notice of Observation Treatment and Im
A proposed rule would expand access and use of claims data and analysis, cms
CMS extended the deadline for streamlined meaningful use cms.gov/Regulations
CMS held a webinar on May 12 explaining the methodology and upcoming changes to its controversial
In response to CMS’ final emergency preparedness rule issued earlier this month,
SEPTEMBER 26, 2017
ACCREDITATION DEPARTMENT
CMS will delay an update to its controversial hospital star rating system for the second time in
OCTOBER 10, 2017
ACCREDITATION DEPARTMENT
Each year CMS revises its cms.gov/Outreach-and-Education/Medicare-Learning-N
JANUARY 30, 2018
ACCREDITATION DEPARTMENT
CMS releases July 2015 quarterly Medicare Part B drug pricing files and revisions&n
CMS releases July 2015 quarterly update for DMEPOS competitive bidding program
 CMS proposes aligning its conditional packaging logic with how it applies packaging to labs
Contractors given discretion to deny 'related' claims On August 8, CMS
CMS updates information for billing screening services On April 3, CMS
Use of claim adjustment reason (CARC) code 23 On November 14, CMS issued a transmi
CMS rescinds and replaces Transmittal 166 for technical correction On M
CMS’ recently released 2015 IPPS final rule focuses on quality initiatives mandated by the
Last Tuesday, CMS announced a forthcoming model to expand its accountable care organization (ACO)
by Josh Poltilove CMS has just given itself an additional year — until Nov
CMS issues revision of calendar year (CY) 2014 Annual Update for clinical laboratory fe
CMS releases National Coverage Determination for single and dual chamber permanent card
In a new blog post, CMS announced that it was extending its electronic clinical quality measure (
JANUARY 24, 2017
ACCREDITATION DEPARTMENT
CMS indicated in the 2014 OPPS Final Rule that it will implement 29 new device-dependent c
CMS released the cms.gov/Medicare/Coding/ICD10/2015-ICD-10-PCS-and-GEMs.html"
CMS' introduction of the 2-midnight rule in the 2014 IPPS final rule makes properly identi
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due t
Q: Now that October has arrived, has CMS made any corrections to the information effect
For any new skin substitute products approved for payment during 2014, CMS will use a $32
Since the implementation of the Hospital Value-Based Purchasing Program (HVBP) in 2013, CMS has a
CMS releases ICD-10 conversion update for NCDs On March 6, CMS released
Proposed CMS quality measure reporting requirements detailed in the 2016 prospective payment rule
JUNE 23, 2015
ACCREDITATION DEPARTMENT
  CMS releases coverage criteria for TAVR volume requirements 
On July 2, CMS rescinded Transmittal 1481, dated March 27, 2015, and replaced it wi
CMS continues to update payment logic for comprehensive APCs (C-APC) with additional chang
[Editor’s Note: CMS updated the cms.gov/Medicare/Coding/
For 2015, CMS finalized changes to reconfigure and consolidate ophthalmology and gynecolog
On August 6, CMS released a change request amending payment files that were issued to contractor
On August 28, CMS released a recurring update notification stating that the payment allowances fo
SEPTEMBER 22, 2015
PHYSICIAN PRACTICE DEPARTMENT
Q: Is CMS adding any items with pass-through status for 2016? We are starting to look at rei
CMS does not require ordering providers to rewrite orders prior to ICD-10 implementation with app
NOVEMBER 18, 2015
JUSTCODING
We recently talked a little about a new proposed rule that CMS published in the November 3
DECEMBER 1, 2015
CASE MANAGEMENT DEPARTMENT
CMS recently clarified policy on acceptable control materials for lab testing. While not changing
APRIL 26, 2016
ACCREDITATION DEPARTMENT
Last week, CMS published a list of proposed rule changes for
JUNE 21, 2016
ACCREDITATION DEPARTMENT
The site-neutral payment provision in CMS’ 2017 OPPS proposed rule could level the playing
The Centers for Medicare & Medicaid Services (CMS) released a memorandum on October 21, 2016,
by: Josh Poltilove   Hospices that received letters from CMS indicating they
On March 17, CMS announced a blanket 1135 Waiver to expand the use of telehealth, which provides
CMS continued its focus on improving the quality of patient care in the
OCTOBER 7, 2015
JUSTCODING
Every year, the Office of Inspector General (OIG) makes recommendations to CMS to ensure federal
DECEMBER 11, 2020
LONG-TERM CARE DEPARTMENT
by: Josh Poltilove Experts fear a lack of detailed surveyor training from CMS on
CMS clarifies coverage of extracorporeal photopheresis  On August
CMS releases April 2015 I/OCE specifications On March 13, CMS released
CMS releases October 2014 OPPS update  On August 1, CMS relea
CMS releases July 2015 update of the hospital OPPS  On June 5, CMS
by A.J. Plunkett (aplunkett@decisionhealth.com) Check CMS and CDC online
APRIL 19, 2020
SAFETY DEPARTMENT
On Thursday evening, CMS confirmed that it plans to implement ICD-10 as soon as it is allow
New standards from The Joint Commission designed to align with the CMS will go into effect on Jul
JUNE 24, 2014
ACCREDITATION DEPARTMENT
What are regulators really looking for from your medical staff services department? When CMS see
  Providers expected October 1, 2015, to be the new ICD-10 compliance date and CMS
CMS updates information for billing screening services On April 3, CMS released a c
CMS revises travel allowance fees for collection of specimens  On
A new CMS report found that the agency paid more than $380 million in incentive payments through
APRIL 28, 2015
ACCREDITATION DEPARTMENT
On June 25, CMS posted a fact sheet about the Accountable Care Organization (ACO) Investment Mo
On September 21, CMS released a fact sheet stating Medicare Advantage and Part D will continue to
On December 10, CMS posted a fact sheet and press release detailing new measures added and inform
DECEMBER 29, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS recently expanded the amount of data available on its 
On March 8, CMS posted a document in the Federal Register correcting technical and typog
On July 20, CMS released a special edition MLN Matters article reminding physicians of t
On July 29, CMS issued a final rule (CMS-1645-F) outlining FY 2017 Medicare payment policies and
AUGUST 5, 2016
LONG-TERM CARE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) announced Phase 2 of their initiative to &
On March 20, CMS released cms.gov/Outreach-and-Education/Medicare-Learning-N
On April 14, CMS published cms.gov/Regulations-and-Guidance/Guidance/Tra
On May 30, CMS published a cms.gov/Newsroom/MediaReleaseDatabase/Press-relea
On Aug. 22, CMS issued a cms.gov/Medicare/Provider-Enrollment-and-Certi
SEPTEMBER 4, 2017
PHYSICIAN PRACTICE DEPARTMENT
This change is significant but not terribly surprising.   CMS has signaled it
The Joint Commission (TJC) is revising five elements of performance (EP) following a CMS review o
DECEMBER 1, 2018
ACCREDITATION DEPARTMENT
What are the home health CMS & the Medicare/Medicaid Policy for PTA supervision by a
  CMS and AMA announce efforts to ease transition to ICD-10 for providers
CMS replaces transmittal for Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) for s
Claims that are related   On September 12, CMS release
SEPTEMBER 23, 2014
CORPORATE COMPLIANCE DEPARTMENT
Claims that are related On September 12, CMS released a fourth version
The American Medical Association (AMA) addressed weaknesses in CMS’ EHR Incentive Programs and
CMS hopes to gain a better understanding of when and why providers use modifier -59 (disti
Last Tuesday, CMS issued cms.gov/Regulations-and-Guidance/Guidance/Transmitta
Q: Did CMS make any changes to drug payments for April?  
ICD-10 implementation is 27 days away. CMS completed its third and final ICD-10 end-to-end testin
The 2016 OPPS proposed rule released July 2 is deceptively short, but packs a punch. CMS i
On November 16, CMS released a final rule that bundles acute care payments for knee and hip repla
DECEMBER 8, 2015
CASE MANAGEMENT DEPARTMENT
CMS recently updated its Clinical Laboratory Amendments (CLIA) for lab work at critical access ho
APRIL 12, 2016
ACCREDITATION DEPARTMENT
After missing a proposed fall start date, CMS has announced last week that its Medicare Part B dr
DECEMBER 27, 2016
PHYSICIAN PRACTICE DEPARTMENT
Industry stakeholders seek clarity from CMS about draft interpretive guidelines.
CMS announced proposed changes to the Medicare long-term care requirements that would reform &ldq
SEPTEMBER 6, 2019
LONG-TERM CARE DEPARTMENT
By A.J. Plunkett (aplunkett@decisionhealth.com) CMS wants The Joint Comm
DECEMBER 21, 2019
SAFETY DEPARTMENT
by: Megan Herr CMS is working to incorporate new improvements to Medciare.gov to
Providers have until Monday, March 24, to sign up for CMS' ICD-10 end-to-end testing that will oc
Patients have a new resource to use when choosing a nursing home.   CMS an
Q: We don’t quite understand the CMS' new Comprehensive APCs (C-APC) and how to c
CMS finalized a number of coding and MS-DRG changes as part of the fiscal year 2016 IPPS final ru
AUGUST 12, 2015
JUSTCODING
CMS issued its first update this week on how ICD-10 implementation has impacted the industry and
While CMS’ new payment rule bundling hip and knee replacement surgeries may have sparked so
DECEMBER 15, 2015
CASE MANAGEMENT DEPARTMENT
CMS recently released its seventh maintenance update for National Coverage Determinations (NCD)
On July 7, CMS posted a cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/20
A proposed CMS change to the 2017 Medicare Physician Fee Schedule will require surgeons document
SEPTEMBER 13, 2016
ACCREDITATION DEPARTMENT
On December 2, CMS published cms.gov/Regulations-and-Guidance/Guidance/Trans
DECEMBER 13, 2016
PHYSICIAN PRACTICE DEPARTMENT
On December 8, CMS published a cms.gov/Newsroom/MediaReleaseDatabase/Fact-sh
DECEMBER 27, 2016
PHYSICIAN PRACTICE DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) posted the second annual release of the ho
On April 3, CMS revised cms.gov/Outreach-and-Education/Medicare-Learning
A Q&A around drug regimen review items was provided by CMS.   CMS’
This article originally appeared in cms-cites-baltimore-ho
MARCH 22, 2018
NURSING DEPARTMENT
Correction notice to IPPS final rule On March 18, CMS and HHS issued a
CMS updates contractor instructions for enrollment and re-enrollment applications
CMS updates contractor instructions for enrollment and re-enrollment applications
CMS updates contractor instructions for enrollment and re-enrollment applications  
CMS revises travel allowance fees for collection of specimens On January 23, CMS re
Home Health Star Rating previews are now available to agencies CMS has an
CMS offers five solutions to help address inadequate HIPAA Security Rule–requ
Just in time for the holidays, CMS is offering the gift of a newly revised State Operations Manua
DECEMBER 23, 2019
SAFETY DEPARTMENT
On April 10, 2020, CMS issued a proposed rule
Update to surety bond collection procedures On May 16, CMS released a change request
Provider Reimbursement Manual update  On May 23, CMS released
CMS issues 2014 annual update for Clinical Laboratory Fee Schedule and Laboratory Servi
Providers probably weren't surprised that CMS continued its push to increase packaging in
Last week, CMS sent out a message on its provider list servs informing home health agencies that
Implementation date for laboratory travel allowance fee updated On February 5, CMS r
CMS recently announced that the star rating methodology soon to augment Home Health Compare will
CMS has released additional resources to assist eligible professionals (EP) participating in its
DECEMBER 15, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS seeks comments on OASIS C2 CMS has opened the comment period
CMS is proposing to remove one of the rating categories for the Home Health Quality Patient Star
by Kirsten Dize CMS released the final OASIS-D guidance manual less than two wee
CMS releases 2015 annual update for HPSA bonus payments  On Octobe
Providers need to be aware of new modifiers added by CMS in the
NOVEMBER 25, 2015
JUSTCODING
CMS finalized its proposals regarding the 2-midnight rule, including moving responsibility for ru
DECEMBER 9, 2015
JUSTCODING
By A.J. Plunkett CMS is urging hospitals and other providers to review their plans
FEBRUARY 13, 2020
SAFETY DEPARTMENT
CMS revises Medicare systems to accurately process inpatient hospital claims, MSP claims
In annual report to Congress, CMS says accreditation organizations have their work cut out for t
NOVEMBER 1, 2017
SAFETY DEPARTMENT
  In the 2016 IPPS final rule, CMS added three new claims-based measures and one s
OCTOBER 7, 2015
JUSTCODING
Expect CMS surveyors to be referring to recommendations set out by The Joint Commission (TJC) las
OCTOBER 1, 2018
SAFETY DEPARTMENT
by Kirsten Dize CMS is seeking to reduce agency payments even more than expected
CMS revisions regarding therapeutic diet orders may give MSPs plenty to chew on
NOVEMBER 1, 2014
MEDICAL STAFF DEPARTMENT
CMS releases July 2014 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files
CMS continues to update payment logic for comprehensive APCs (C-APC) with additional chang
AUGUST 5, 2015
JUSTCODING
by Josh Poltilove CMS’ plan to eliminate “Influenza im-munization rec
After several requests, CMS finally issued a waiver for some — but not all — equipmen
MAY 8, 2020
SAFETY DEPARTMENT
For anyone who has not yet started ICD-10 training, CMS posted a transcript, audio file, a
JUNE 18, 2014
JUSTCODING
Payment adjustment for FY 2014 extended On June 16, CMS pos
When CMS releases rules, the length can be intimidating. But even at a relatively slim 700
CMS will delay implementation of a chart-abstracted sepsis measure included in the IPPS fi
SEPTEMBER 10, 2014
JUSTCODING
Effective immediately, the CMS is offering a categorical waiver allowing hospitals to use power s
SEPTEMBER 30, 2014
ACCREDITATION DEPARTMENT
CMS removed two add-on procedure codes from the inpatient-only list in the 2015 OPPS final
  The Centers for Medicaid and Medicare Services (CMS) issued a draft rule late Fr
APRIL 14, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
The policies that CMS publishes each year in the OPPS proposed rule don't always come as a
The Centers for Medicare & Medicaid Services (CMS) is 
The Joint Commission revised several hospice requirements to comply with the CMS Conditions o
CMS should have addressed the 2-midnight rule, but didn’t in the fiscal year 2016 IPPS prop
CMS announced July 14 that its advanced analytics system, the Fraud Prevention System, ide
CGI posted one new issue in one category to its CMS list for providers in Region B. (See link for
CMS implemented two new CPT® Category III codes originally introduced by th
Q: Will CMS be adding any new drugs or biologicals to its pass-through list in i
On December 22, 2015, CMS made public Transmittal 216 and Transmittal 3428 to r
CMS changed the status indicator for CPT code 99497 (advance care planning including the explanat
On January 28, CMS posted a fact sheet regarding a proposed rule that would update the methodolog
On February 5, CMS released a change request stating CMS has determined that for dates of service
FEBRUARY 23, 2016
PHYSICIAN PRACTICE DEPARTMENT
On February 5, CMS released a change request to inform contractors that CMS has determined that t
FEBRUARY 23, 2016
PHYSICIAN PRACTICE DEPARTMENT
CMS launched a voluntary five-year physician payment program dubbed cms.gov/
CMS’ annual cms.gov/Research-Statistics-Data-and-Systems/Statistics-Tr
Ten critical access hospitals (CAH) have agreed to take part in CMS’
AUGUST 9, 2016
ACCREDITATION DEPARTMENT
CMS reports that between 2012 and 2015, accountable care orga
AUGUST 30, 2016
ACCREDITATION DEPARTMENT
This technical report,cms.gov/files/hhgm technical report 120516 sxf.p
More than 359,000 providers will participate in CMS’ cms.gov/Newsroom/
The OASIS-C2 Q&As that CMS posted Feb. 24 finally offer direction in writing on how to answer
The Centers for Medicare & Medicaid Services (CMS) has released a memorandum to the state sur
by: Kirsten Dize CMS released the 2018 guidance manual for OASIS-C2 on August 4.
November marks Home Care and Hospice month, according to CMS. Now is the time to ensure your comm
CMS doesn't require Medicare Advantage plans to have a face-to-face document for home health. Bu
A newly proposed rule by CMS would put into effect new discharge planning requirements that the a
SEPTEMBER 26, 2019
SAFETY DEPARTMENT
It’s getting closer to the end of the value-based purchasing pilot program and CMS
CMS addressed a question about whether agencies should discharge a patient when a home health pat
CMS recently made its cms.gov/Outreach-and-Education/Medicare-Learning
JUNE 11, 2014
JUSTCODING
  CMS' Comprehensive Error Rate Testing (CERT) program found "many" impr
MAY 14, 2014
JUSTCODING
Due to the continued delay in awarding new Recovery Auditor (RA) contracts, CMS made modification
  CMS released MLN Matters® cms.gov/Outreach-and-Ed
Coders will find 50 new codes in ICD-10-PCS for 2016, according to cms
JUNE 17, 2015
JUSTCODING
With less than one month until implementation, CMS says it’s ready for ICD-10, and so are m
SEPTEMBER 8, 2015
PHYSICIAN PRACTICE DEPARTMENT
By Steven Andrews   CMS issued its first update this week on how I
The Centers for Medicare and Medicaid Services (CMS) has taken another step toward ensuring tha
NOVEMBER 13, 2015
LONG-TERM CARE DEPARTMENT
This month, CMS plans to add a new “five-star” hospital rating system to its
APRIL 19, 2016
ACCREDITATION DEPARTMENT
CMS recently released its seventh maintenance update for National Coverage Determinations (NCD) t
In the last week of September, CMS gave $347 million to 16 different hospital associations, Quali
OCTOBER 4, 2016
ACCREDITATION DEPARTMENT
One proposal that would have an enormous impact on a large number of hospitals is CMS’ prop
Facilities have less than 20 days to fully comply with CMS’ new emergency preparedness rule
OCTOBER 26, 2017
SAFETY DEPARTMENT
Last Tuesday, NAHC submitted official comments to CMS on a pair of proposed clinical templates (o
by: Kirsten Dize CMS’ revised OASIS Q&A document offers welcome insight
Home health agencies can seek a little comfort in the relaxed provisions that CMS has put in plac
On November 5, the Centers for Medicare & Medicaid Services (CMS) released corrections
NOVEMBER 15, 2013
LONG-TERM CARE DEPARTMENT
  The new ICD-10 implementation date is less than a year away, and CMS is gearing
By Steven Andrews   This week, CMS released
  Q: Did CMS add any new codes for drugs that have pass-through status this mon
I have some questions regarding the CMS Instruction for Medical Review on Home Health Ce
On July 13, CMS and the Food and Drug Administration [FDA] sent a
JULY 19, 2016
ACCREDITATION DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) has updated the lists of HCPCS codes that
In the new proposed home health PPS rule, CMS states agencies providing a larger percentage of ov
CMS has contracted with an SMRC to lower improper payment rates
SEPTEMBER 1, 2014
LONG-TERM CARE DEPARTMENT
CMS has long identified staffing as one of the vital components of a nursing home’s
APRIL 10, 2015
LONG-TERM CARE DEPARTMENT
by: Josh Poltilove Some hospice industry experts were taken aback by CMS&rs
by Josh Poltilove CMS is proposing to eliminate three requirements it has deemed
by Josh Poltilove A new change request from CMS implements the policies of the
CMS surveyors are starting to survey home health agencies for infection-control issues. T
ESRD PPS and Quality Incentive Program (QIP) On July 1, CMS posted the E
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
SAFETY DEPARTMENT
 Be prepared to ask for time extensions from your accrediting organization and CMS to bring
OCTOBER 1, 2018
SAFETY DEPARTMENT
On May 2, CMS released a change request to update various sections of Chapter 15 of t
Last Thursday, CMS issued a cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets
After considering a number of stakeholder requests, CMS has extended the deadline for lon
CMS posts quarterly listing of program issuances On August 3, CMS post
The Centers for Medicare and Medicaid Services (CMS) and Office of the National Coordinator for H
How CMS and Joint Commission decide what accreditation program to put you in The differ
FEBRUARY 1, 2018
ACCREDITATION DEPARTMENT
CMS released an updated memo on April 24 to state surveyors reiterating previous guidance about h
CMS updates Chapter 3 of the Program Integrity Manual (PIM)  
For the sixth year in a row, CMS and the AMA made no changes to CPT® coding or bil
FEBRUARY 10, 2015
PHYSICIAN PRACTICE DEPARTMENT
CMS has instructed MACs to reprocess claims and providers to reimburse beneficiaries due t
OCTOBER 1, 2014
JUSTCODING
The cms.gov/Medicare/Coding/OutpatientCodeEdit/OCEQtrReleaseSpecs.html
FEBRUARY 18, 2015
JUSTCODING
CMS bumps up SNF payment rate increase in FY 2015 proposal
AUGUST 1, 2014
LONG-TERM CARE DEPARTMENT
CMS identified no major problems and a minimal error rate due to invalid coding during its
MARCH 4, 2015
JUSTCODING
CMS released cms.gov/Regulations-and-Guidance/Legislation/EHRIncentiveProgra
FEBRUARY 23, 2016
PHYSICIAN PRACTICE DEPARTMENT
On June 2, CMS issued a new cms.gov/Medicare/Provider-Enrollment-and-Certifi
Another mixed bag of stuff for you this week, leading off with a quick spin through CMS’ re
NOVEMBER 1, 2018
SAFETY DEPARTMENT
by Kirsten Dize and Megan Herr The latest release of CMS’s quarterly OASIS
CMS CoPs New final rule refines and redefines medical staff
AUGUST 1, 2014
MEDICAL STAFF DEPARTMENT
 by Debbie Mackaman, RHIA, CPCO, CCDS CMS released the 2017 OPPS proposed r
A query by CMS officials questioning whether accrediting organizations (AO) that also offer consu
APRIL 1, 2019
ACCREDITATION DEPARTMENT
After several requests, CMS finally issued a waiver for some—but not all—equipment in
JULY 25, 2020
SAFETY DEPARTMENT
In a new memo to its state survey agencies, CMS said it would use Joint Commission ligature recom
In a new memo to its state survey agencies, CMS said it would use Joint Commission ligature recom
OCTOBER 1, 2018
ACCREDITATION DEPARTMENT
CMS issued its final rule, Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursi
NOVEMBER 15, 2019
LONG-TERM CARE DEPARTMENT
A CMS investigation accuses a physician at St. Joseph’s Hospital Health Center in Sy
APRIL 8, 2014
ACCREDITATION DEPARTMENT
The new ICD-10-CM/PCS implementation date looks to be October 1, 2015. CMS mentioned October
The CMS made hospital quality improvement a major part of its fiscal year 2015 Inpatient Prospect
AUGUST 12, 2014
ACCREDITATION DEPARTMENT
CMS released a Special Edition MLN Matters article regarding frequently asked questions fo
The period for physicians to review and dispute financial information reported under CMS&r
APRIL 9, 2015
MEDICAL STAFF DEPARTMENT
For 2015, CMS identified 219 HCPCS/CPT codes as good candidates for comprehensive APCs (C-
This year has brought a lot of CMS work this year, both in preparation for impending visits and i
JUNE 4, 2015
SAFETY DEPARTMENT
By Steven Andrews   CMS deferred making any updates to the 2-
  As part of the cms.gov/Outreach-and-Education/Medicare-Learn
Now that CMS and The Joint Commission are placing greater emphasis on emergency management, this
JULY 29, 2015
INFECTION CONTROL, QUALITY & PATIENT SAFETY DEPARTMENT
Q: Did CMS make any changes to skin substitutes for October?  
OCTOBER 7, 2015
JUSTCODING
On November 9, CMS released a transmittal providing instructions for payment and CWF edits to be
On November 16, CMS posted the final rule with comment period addressing changes to the physician
According to a CMS report of 2014 results for the Pioneer ACO Program and the Medicare Shared Sav
DECEMBER 29, 2015
PHYSICIAN PRACTICE DEPARTMENT
On January 12, CMS released a transmittal updating the interest rate on overpayments and underpay
The OASIS-C2 item stet is now available on the Ocms.gov/Medicare/Quality-Ini
On April 12, CMS released a recurring update notification regarding the interest rate effective A
On August 24, CMS rescinded Transmittal 3594, dated August 19, and replaced it with
SEPTEMBER 6, 2016
PHYSICIAN PRACTICE DEPARTMENT
On September 9, CMS released a recurring update notification providing the availability of paymen
SEPTEMBER 20, 2016
PHYSICIAN PRACTICE DEPARTMENT
On October 13, CMS published a fact sheet announcing an 18-month pilot program to reduce medical
On Wednesday, October 12, 2016, CMS posted Transmittal 273, regarding Medicare Regulatio
On September 29, CMS released a change request providing instructions for payment and edits for t
On January 11, CMS published cms.gov/Regulations-and-Guidance/Guidance/Trans
Or extend your hand? First up, as a general rule of thumb ... when CMS identifies an im
APRIL 13, 2017
SAFETY DEPARTMENT
On April 21, CMS published cms.gov/Regulations-and-Guidance/Guidance/Tra
CMS states in its comments that claims for “questionable encounters” will be returned
The Centers for Medicare & Medicaid Services (CMS) has released its final PPS Rule for 2017 a
Q: Is there a mandated plan from CMS to complete PPS assessments on managed ca
Yes, it’s true. You can find that requirement in CMS Publication 100-2, Chapter 7,
CMS announced it has extended its enforcement delay of the 2-midnight rule from September 30 to J
SEPTEMBER 1, 2015
CASE MANAGEMENT DEPARTMENT
The CMS system will automatically change the answer to M2200 to reflect the number of visits repo
Scott Mace for HealthLeaders Media What are we to make of CMS Acting Admi
In the final days of 2015, CMS released a draft of OASIS-C2. The document includes some minor cha
It’s the second year for cms.gov/Medicare/Medicare-Fee-for-Service-Pay
MARCH 15, 2016
ACCREDITATION DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS) released the Next Steps Toolkit to help y
APRIL 22, 2016
LONG-TERM CARE DEPARTMENT
CMS is hosting a 2-day, in-person training event on August 9 and 10 for the Inpatient Rehabilita
The CMS system will automatically change the answer to M2200 to reflect the number of visits repo
NAHC submits recommendations to CMS regarding the hospice cost report
A couple of weeks ago, the friendly folks at CMS issued notice of a proposed regulation change fo
MAY 4, 2017
SAFETY DEPARTMENT
The Centers for Medicare & Medicaid Services (CMS), issued the Q4 of FY2016 PEPPER report. Th
Take a close look at the documentation guidelines that CMS suggests for the practice improvement
CMS has now issued guidance permitting hospices seeking to correct their payments for RHC and SIA
by Josh Poltilove Editor's note: CMS and its contractor, the RAND Corporation, explai