Medicare Compliance & Reimbursement
CMS Settles Appeals Suit
Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commission will review whether Medicare should cover verteprofin for certain types of macular degeneration. CMS will have 60 days to accept, or to reject with a public explanation, the MCAC panel's recommendation. An agency spokesperson said the same process would be available for people unhappy with other NCDs. The settlement comes in the suit filed on Aug. 6, 2002, by Lois Jalbert and other victims of the eye disease. The plaintiffs sued over the Centers for Medicare & Medicaid Services' failure to institute an appeals mechanism for national coverage decisions. Under the settlement, plaintiffs may refile their suit if CMS does not issue a final regulation implementing an NCD appeals process by Oct. 31, 2003.
Medicare Compliance & Reimbursement
- Medicare Rx:
MEDICARE OVERHAUL ADVANCES IN HOUSE
Medicare beneficiaries would receive 100 percent coverage of drug expenses after spending $3,500 out-of-pocket under [...] - Medicare Rx:
SENATE BILL STILL ON PATH TO PASSAGE
In the Senate, there is still a ways to go before a final product. However, [...] - Medicare Rx:
WHITE HOUSE Key To Medicare Reform
Most Democrats supporting Grassley-Baucus would not support the direct competition between FFS Medicare and private [...] - Medicare Rx:
FINANCIAL ANALYSTS: DRUG-ONLY PLANS A NO-GO
The Medicare prescription-drug legislation being debated in Washington proposes private drug-only insurance plans - presumably [...] - Specialty Hospitals:
CMS CAN'T, CONGRESS MIGHT CAN WHOLE-HOSPITAL EXEMPTION
The rise of specialty hospitals funded mainly by physician investors is a recent phenomenon that [...] - MedPAC:
MEDPAC PUSHES PAY FOR MEDPAC PUSHES PAY FOR
To provide high-quality, cost-effective treatment, Medicare must launch demonstration projects exploring financial-reward systems for top-quality [...] - Enforcement:
WHAT'S TOPPING FRAUD-FIGHTERS' TO-DO LISTS
Perhaps the top activity for state and federal fraud busters these days is following pharmaceutical [...] - SCHIP:
Finance Acts To Preserve SCHIP Funds
The Senate Finance Committee June 12 unanimously approved legislation to prevent states from losing $2.7 [...] - Hospitals:
HOSPITALS OUTCOMES DEMO TO GO FORWARD
Agreement has been reached on terms of a Medicare demonstration project that would give hospitals [...] - Hospitals:
BEEF UP YOUR POST-ACUTE TRANSFER COMPLIANCE
Hospitals with high error rates for post-acute transfers could be in for aggressive enforcement actions [...] - Hospitals:
SMALL FACILITIES HIT HARDEST BY CLOSURES
In rural and urban settings alike, smaller hospitals that treat fewer patients than their peers [...] - Coverage:
CMS Settles Appeals Suit
Under a May 27 legal settlement, a dozen experts from the Medicare Coverage Advisory Commission [...] - Coverage:
ICD COVERAGE EXPANDS- BUT ONLY SLIGHTLY
Health care providers will soon be able to bill Medicare for implantable cardioverter defibrillators in [...] - Bill Watch
The following House bills were introduced: H.R. 2471. A bill to amend title XVIII of [...] - Register Watch
Looking for continuing education credits? Look to CMS. The Centers for Medicare & Medicaid Services [...]
