Phase 2 (2016): As a part of its continued efforts to assess compliance with the HIPAA Privacy, Security and Breach Notification Rules, the HHS Office for Civil Rights (OCR) has begun its next phase of audits of covered entities and their business associates. Audits are an important compliance tool for OCR that supplements OCR’s other […]
The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) released a new interactive map to increase understanding of geographic disparities in chronic disease among Medicare beneficiaries. The Mapping Medicare Disparities (MMD) Tool identifies disparities in health outcomes, utilization, and spending by race and ethnicity and geographic location. Understanding geographic differences in […]
The Skilled Nursing Facility Utilization and Payment Public Use File (SNF PUF) contains information on utilization, payments, and submitted charges organized by provider, state, and resource utilization group (RUG). The data include information on 15,055 skilled nursing facilities, over 2.5 million stays, and almost $27 billion in Medicare payments for 2013. The data set does […]
The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing to […]
The Centers for Medicare & Medicaid Services (CMS) issued the final annual Notice of Benefit and Payment Parameters for the 2017 coverage year, along with related guidance documents, as part of our ongoing efforts to promote healthy and stable markets that works for consumers and for insurers. The rule finalizes provisions to: help consumers with […]
Posting of ambulance, home health utilization data follows recent provider and supplier moratoria extension The Centers for Medicare & Medicaid Services (CMS) released two public data sets regarding the availability and use of services provided to Medicare beneficiaries by ground ambulance suppliers and home health agencies, as well as a list of Medicare fee-for-service (FFS) […]
Please find the following links covering various topics and updates related to Ebola from the CDC. Outbreak Update – October 25, 2014 Interim Guidance: EMS Systems & 9-1-1 PSAPs: Management of Patients in the U.S. – Updated October 24, 2014 Recommendations for Safely Performing Acute Hemodialysis in Patients with Ebola Virus Disease in U.S. Hospitals […]
According to this announcement from CMS, February 21, 2014 is the last day a Recovery Auditor may send a postpayment Additional Documentation Request (ADR).
CMS has provided an FAQ document to address concerns regarding the 2 Midnight Inpatient Admission Guidance which begins October 1, 2013. Click to read the document on the CMS site. Q: Will CMS direct the Medicare review contractors to apply the 2-midnight presumption-that is, contractors should not select inpatient claims for review if the inpatient […]