Articles and Blogs

This week, the Centers for Medicare & Medicaid Services (CMS) updated Section 40.1 of Publication 100-1, the Medicare General Information, Eligibility and Entitlement Manual, to reflect Section 3108 of the Patient Protection and Affordable Care Act (PPACA).  This update permits physician assistants to perform the initial certifications and recertifications of a beneficiary’s need for skilled... 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... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has reevaluated the revalidation requirements in the Affordable Care Act (“ACA”), and believe the ACA allows for the extension of the revalidation period for an additional two years.  This will extend the deadline for revalidation through March of 2015.  Providers are reminded that if they have... READ MORE

CMS has just released the highly anticipated final regulations for accountable care organizations (ACOs) under Section 3022 of the Affordable Care Act (ACA).  The ACA requires accountable-care agreements to be offered under Medicare, starting in 2012.  READ MORE

CMS recently published a Survey & Certification Memorandum (S&C:11-35-NH) detailing progress in the implementation of Section 6121 of the Affordable Care Act (ACA).  Section 6121 of the ACA mandates enhanced nurse aide training in nursing homes.  The enhanced training focuses on two areas: 1) how to care for residents with dementia, and 2) how... READ MORE

Earlier this week, we highlighted the implementation by Centers for Medicare & Medicaid Services (CMS) of enrollment revalidations and screening categories, and which categories CMS places certain long-term care providers. It is important for providers and suppliers to understand what each screening category (limited, moderate, or high) entails and be aware of any events... READ MORE

As an update to the previous post on the revalidation enrollment procedures it is important for hospices, home health agencies, and DMEPOS to know what level of screening they will receive from the Medicare Administrative Contractor (“MAC”).  In some instances these providers and suppliers will be screened at either a “high” or “moderate” level... READ MORE

As of March 2011, the Centers for Medicare & Medicaid Services (CMS) implemented new screening criteria in the Medicare provider/supplier enrollment process.  Newly enrolling and revalidating providers and suppliers are placed in one of three categories – limited, moderate, or high – each representing the level of risk to the Medicare program for that... READ MORE

Effective fiscal year (FY) 2012, The Centers for Medicare & Medicaid Services (CMS) final rule on Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012, released July 29, reduces Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments by 11.1%. CMS states this action was taken to “better align... READ MORE

The Centers for Medicare & Medicaid Services (CMS) increased fiscal year (FY) 2012 Medicare payments by 2.5% for hospice providers in a final regulation released July 29.  Also included in the final regulation are requirements for hospice providers to start collecting quality of care data and changes to the way CMS counts hospice patients... READ MORE