Medicare Compliance & Reimbursement
M+C 2004 ACRP TIMELINE
The Medicare Prescription Drug, Improvement and Modernization Act (DIMA) is up and running and means immediate changes for Medicare+ Choice organizations. Rates are set to increase as of March 1, 2004, and M+COs can choose to enhance benefits, decrease premiums or cost-sharing, contribute to a benefit stabilization fund or stabilize or enhance beneficiary access to their providers. Under DIMA, the Centers for Medicare & Medicaid Services now may allow organizations that left the M+C program in 2002 or 2003 to reenter in the new DIMA adjusted community rate proposal season. Here is what plans need to watch for:
For more questions and answers regarding the immediate DIMA provisions, see: http://cms.hhs.gov/healthplans/acr/.
Medicare Compliance & Reimbursement
- Regulations:
DOZENS OF REGULATORY CHANGES IN THE PIPELINE
What's coming down the pike from CMS and the OIG.
Medicare's regulatory framework is a [...] - Physicians:
CMS RINGS IN THE NEW YEAR WITH PHYSICIAN PAY HIKE
Starting January 1, physicians can see it to believe it.
Good news for physicians - [...] - Home Care:
NEW HOME CARE PPS RATES MAY CHANGE MORE THAN EXPECTED
HHAs prepare for inflation update revamp.
The market basket index for home health agencies is [...] - Health Savings Accounts:
IRS ISSUES GUIDELINES FOR NEW TAX-FAVORED ACCOUNTS
The Internal Revenue Service in new guidelines outlines the broadly favorable tax treatment and other [...] - Medicare Rx:
REALITY: MEDICARE MAY NEED TO SET SOME Rx PRICES
Health economist Joseph Newhouse predicts that the Medicare prescription-drug law's "non-interference clause," which prohibits the [...] - Medicare+Choice:
SENIORS IN FOR-PROFIT PLANS NOT DENIED HIGH-COST CARE
At least in the Medicare program, for-profit managed care plans provide as much access to [...] - Hospice:
COPs, Amendments On Hospice Horizon
Hospices have their fair share of regulatory action planned this year. According to the Centers [...] - Pharmaceuticals:
CMS TACKLES AWP
In one of its first steps towards turning the sprawling Medicare legislation signed by President [...] - People:
SMITH BECOMES ACTING CMS CHIEF
Former Centers for Medicare and Medicaid Services Administrator Tom Scully has joined the law firm [...] - Medicare+Choice:
M+C 2004 ACRP TIMELINE
To be ready for the changes in March, M+COs need to act now.
The Medicare [...] - Pharmaceuticals:
CMS BEEFS UP DRUGMAKER RECORDKEEPING RULE
Time limitation bumped up to 10 years.
Drug makers will need to hold onto pricing [...] - Pharmaceuticals:
MEDICAID Rx SCRUTINY placed on DOCS, PHARMACISTS, PATIENTS
Watch for yet more investigation of suspected prescription drug fraud .
Big players in the [...] - Hospitals:
MORE LIFE SUPPORT FOR RURAL HOSPITALS
New rule secures cash flow to rural hospitals, changes payments on certain drugs.
More than [...] - Hospitals:
SMALL TOWN HOSPITALS TO RECEIVE BIG-CITY WAGES
Special appeals for wage index classification are now under way. The Centers for Medicaid & [...] - Self-Referral:
ITS THAT TIME OF YEAR - feds DELAY SELF REFERRAL RULE, AGAIN
Effective date for controversial Stark provision now July 7, 2004.
In keeping with its three [...] - CMS MANUAL UPDATE
Physicians will be able to bill Medicare for HCPCS code J0880 starting Jan. 1, 2003, [...]
