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Three papers summarizing possible options for health system reform, coverage reform and financing reform were released recently by the Senate Finance Committee. The papers summarize a large variety of potential reform mechanisms, as part of Chairman Baucus’ and Ranking Member Chuck Grassley’s (R-IA) health reform effort. “Transforming the Health Care Delivery System: Proposals to Improve […]
May 2009: CMS issued a sample Demand Letter from a RAC. This particular letter is a demand relating to a Complex Review for a Part A Medicare Claim. Sample Demand Letter (PDF format, 5 pgs, 46 KB)
The RAC Appeals Process is not too different from Medicare’s standard Appeals Process. CMS offers this explanation of the process. We have pulled out the most useful links for providers: New Final Rule dated January 17, 2017 updates portions of the Appeals Process. Read the Rule in the Federal Register. A booklet from MLN explaining […]
Statement of Work (SOW) for Recovery Audit Contractor (RAC) Taken from: FedBizOpps.Gov (www.fbo.gov) visit original page HERE Solicitation Number: RFP-CMS-2007-0022 Agency / Office: Department of Health and Human Services / Centers for Medicare & Medicaid Services Download most recent version HERE ( V11072007.doc MS Word doc, 425 KB) Synopsis : Added: August 16, 2007 The […]
Andrea Kraynak, April 15, 2009. CMS continued its efforts this week to educate healthcare providers on the permanent Recovery Audit Contractor program with an Open Door Forum call for Medicare Part B providers on April 14. A similar call for Part A providers was held on April 8. Providers may wish to listen to the […]
HealthLeaders Media, April 16, 2009. A new survey of hospital CIOs finds that the federal government’s $36 billion “carrot” of financial reimbursements to install electronic health records won’t be nearly as powerful an incentive as the “stick” of reduced Medicare reimbursements if they don’t. The survey of 100 hospital CIOs was conducted in March and […]
Health Leaders Media – April 13, 2009. CMS today announced the 14 communities around the nation that have been picked for its three-year pilot project to eliminate unnecessary hospital readmissions that cost Medicare billions of dollars annually in preventable care. A study published this month in the New England Journal of Medicine found that nearly […]
Medical Economics – March 16, 2009. This material originally appeared in the March 6, 2009, issue of Health Lawyers Weekly, a publication of the American Health Lawyers Association (www.healthlawyers.org). On February 27, the Florida District Court of Appeal, First District, found that an insurance carrier forfeits its right under state law to contest the medical […]
HHS/CMS — April 6, 2009. CMS ANNOUNCES 2010 PAYMENT INFORMATION FOR PART C MEDICARE ADVANTAGE PLANS AND PART D PRESCRIPTION DRUG PLANS The Centers for Medicare & Medicaid Services (CMS) today issued the Announcement of Calendar Year (CY) 2010 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies. The Announcement updates and […]
