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Procedures That Will be Paid Only as Inpatient for CY2011 This is a zip file for download. CPT® license agreement required. 2011 OPPS Final Addenda [ZIP, 1.54MB](The 2011 Inpatient Only List is here as Addendum E.) Additional information is found in Part 4 of the Medicare Claims Processing Manual beginning on page 126.
Medicare OPPS Final Rule for FY2011 Published The final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health […]
Physician Leases Self-disclosed in 2008 The former owner of the facility that was known as South Coast Medical Center (SCMC) in Laguna Beach, Calif., agreed to pay more than $72,000 in a civil monetary penalty (CMP) settlement concerning leases with providers. After it reported the problematic arrangements to HHS Office of Inspector General (OIG), the […]
Physician Leases Self-disclosed in 2008 The former owner of the facility that was known as South Coast Medical Center (SCMC) in Laguna Beach, Calif., agreed to pay more than $72,000 in a civil monetary penalty (CMP) settlement concerning leases with providers. After it reported the problematic arrangements to HHS Office of Inspector General (OIG), the […]
MEDICARE IMPOSES MARKETING AND ENROLLMENT SUSPENSION ON THREE HEALTH AND DRUG SPONSORS PLAN VIOLATIONS RANGE FROM MARKETING TO RISKS TO HEALTH AND SAFETY OF MEMBERS The Centers for Medicare & Medicaid Services (CMS) today issued a notice to three Medicare health and drug plan sponsors imposing sanctions for violations of Medicare’s rules and regulations. This […]
MEDICARE IMPOSES MARKETING AND ENROLLMENT SUSPENSION ON THREE HEALTH AND DRUG SPONSORS PLAN VIOLATIONS RANGE FROM MARKETING TO RISKS TO HEALTH AND SAFETY OF MEMBERS The Centers for Medicare & Medicaid Services (CMS) today issued a notice to three Medicare health and drug plan sponsors imposing sanctions for violations of Medicare’s rules and regulations. This […]
New Demonstration Programs Support Innovation Center Goals The Centers for Medicare & Medicaid Services (CMS) today formally established the new Center for Medicare and Medicaid Innovation (Innovation Center). Created by the Affordable Care Act, the Innovation Center will examine new ways of delivering health care and paying health care providers that can save money for […]
New Demonstration Programs Support Innovation Center Goals The Centers for Medicare & Medicaid Services (CMS) today formally established the new Center for Medicare and Medicaid Innovation (Innovation Center). Created by the Affordable Care Act, the Innovation Center will examine new ways of delivering health care and paying health care providers that can save money for […]
Indeterminate Descriptions Could Include Over 200 MS-DRGs Connolly Healthcare, the Recovery Audit Contractor (RAC) for 17 states posted 35 new issues on their Approved Issues webpage and removed 4 older issues, mid-day on Wednesday, November 17, 2010. The postings continue the pattern that healthcare providers have come to expect from the 4 RACs and their […]
