January 16, 2018 Via Electronic Submission to www.regulations.gov Seema Verma, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4182-P P.O. Box 8013 Baltimore, MD … [Read more...] about Center Comments on Proposed Rule for Medicare Parts C & D
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November 2017 – Medicare Enrollment & Other Issues
ENROLLMENT IN MEDICARE CMS Steering to Medicare Advantage? The Medicare Annual Coordinated Election Period (ACEP), from October 15th through December 7th, allows Medicare beneficiaries to make certain changes to their Medicare coverage, … [Read more...] about November 2017 – Medicare Enrollment & Other Issues
Annotated Bibliography: Observation Status
Abbey, Duane. “Inpatient Versus Outpatient: The Real Issue.” RAC Monitor. 06 March 2014. http://www.racmonitor.com/rac-enews/1618-inpatient-versus-outpatient-the-real-issue.html (site visited September 21, 2016). The author writes … [Read more...] about Annotated Bibliography: Observation Status
September 2017 – Jimmo Implementation Update & Other Issues
I. JIMMO IMPLEMENTATION UPDATE Background – Jimmo Settlement The settlement in Jimmo v. Sebelius, No. 5:11-cv-17 (D. Vt.) was approved on January 24, 2013. CMS issued revisions to its Medicare Benefit Policy Manual to … [Read more...] about September 2017 – Jimmo Implementation Update & Other Issues
Center Comments on Draft 2018 Medicare Advantage Call Letter
March 3, 2017 VIA ELECTRONIC SUBMISSION AdvanceNotice2018@cms.hhs.gov Cynthia G. Tudor, Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Baltimore, MD 21244 Re: Advance … [Read more...] about Center Comments on Draft 2018 Medicare Advantage Call Letter
Back to the Future: High Risk Pools Annotated Bibliography
Many Americans are greatly concerned that repeal of the Affordable Care Act (ACA) will once again leave people with pre-existing conditions without health insurance. The ACA replacement proposal released by Speaker Ryan on February 16 would move … [Read more...] about Back to the Future: High Risk Pools Annotated Bibliography
CMS Issues Instructions Regarding the Medicare Outpatient Observation Notice (MOON)
Beginning no later than March 8, 2017, and as required by the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act),[1] hospitals and critical access hospitals (CAHs) are required to give patients both oral and written … [Read more...] about CMS Issues Instructions Regarding the Medicare Outpatient Observation Notice (MOON)
Issue Brief: CMS Issues New Rules Governing Medicare Appeals
CMS recently finalized significant changes affecting Medicare appeals, particularly at the Administrative Law Judge (ALJ) level of review. These changes apply to appeals of payment and coverage determinations for items and services furnished to … [Read more...] about Issue Brief: CMS Issues New Rules Governing Medicare Appeals
Court Orders Corrective Action Plan for Government’s Noncompliance with Settlement in Jimmo v. Burwell
In a decision released February 2, 2017, the federal judge overseeing the Settlement Agreement in the Medicare “Improvement Standard” case (Jimmo v. Burwell) ordered the Secretary of Health & Human Services to carry out a Corrective … [Read more...] about Court Orders Corrective Action Plan for Government’s Noncompliance with Settlement in Jimmo v. Burwell
Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017
Effective August 6, 2016, the Notice of Observation Treatment and Implication for Care Eligibility Act (NOTICE Act)[1] requires acute care hospitals to provide oral and written notification to patients who are classified as outpatients or observation … [Read more...] about Hospitals Must Give Patients Notice of Their Observation Status, Beginning March 8, 2017