Articles and Blogs

Oregon election officials took iPads into nursing homes in five Oregon counties for Tuesday’s election.  This effort was under a small pilot program designed to enable the state’s elderly and disabled population to vote.  The iPad was able to accommodate various disabilities, including enlarged font sizes and audible ballot reading for vision impaired voters, and attachments…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has released instructions to prospective Accountable Care Organizations (“ACO”) for applying to the Shared Savings Program. The application process has both automated and paper options, but CMS strongly recommends using the automated application system. All organizations wanting to participate in the Shared Savings Program must submit a Notice…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has released an updated Skilled Nursing Facility (“SNF”) Prospective Payment System (“PPS”) Factsheet.  The revised Factsheet includes background information and elements of the SNF PPS. Should you have any questions, please contact: Todd Selby at 317.977.1440 or tselby@wp.hallrender.com; Brian Jent at 317.977.1402 or bjent@wp.hallrender.com; or David Bufford at 502.568.9368 or dbufford@wp.hallrender.com, or your…Read More

A Medicare beneficiary is not liable for custodial care services rendered by a Mississippi nursing home because the facility failed to give adequate notice the services were not covered by Medicare, a federal appeals court panel ruled on October 25.  The case (Mississippi Care Center of Morton LLC, Sebelius, 5th Cir., No. 10-60595, Oct. 25,…Read More

The Centers for Medicare & Medicaid Services has posted a list of providers who have been sent a request to revalidate their Medicare enrollment information. You can access and review the list, then select “Revalidation Phase 1 Listing.”  The list will be updated monthly and providers are encouraged to review the list.  If you are…Read More

Current regulations (42 C.F.R 424.510(e)(1),(2)) require providers and suppliers to agree to receive Medicare payments via Electronic Funds Transfer (“EFT”) at the time of enrollment, revalidation, change of Medicare contractors or submission of an enrollment change request.  Additionally, the provider or supplier must submit a CMS-588 form to receive Medicare payment via EFT.  Section 1104 of…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has posted a listing of providers who have already been sent a request to revalidate their Medicare enrollment information.  The listing contains the name and National Provider Identifier (“NPI”) of each provider, as well as the date the letter was sent.  Providers on the list, but have…Read More

The Centers for Medicare & Medicaid Services (“CMS”) has made changes to the Medicare Overpayment Notification Process.  If an outstanding balance has not been resolved, providers previously received three notification letters regarding the overpayments:  (1) an initial demand letter, (2) a follow-up letter, and then (3) an intent to refer letter.  CMS would send the second demand…Read More

On November 3, 2011, GlaxoSmithKline (“GSK”) announced an agreement in principle with the U.S. government for the largest settlement to date to conclude ongoing government investigations against a pharmaceutical company marketing products in the U.S.  The $3 billion settlement against GSK, the world’s fourth largest pharmaceutical company, should be finalized in 2012 and is expected…Read More

On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its Calendar Year (CY) 2012 Medicare Physician Fee Schedule Final Rule (Final Rule) finalizing proposed changes that impact physician billing for services subject to a billing policy commonly known as the 3-Day Payment Window Rule (or 1-Day Payment Window Rule for certain…Read More