On February 28, 2018, the United States District Court for the District of New Mexico issued a decision invalidating use of the statewide average premium by the Center for Medicare & Medicaid Services (CMS) in the risk adjustment transfer formula established under section 1343 of the Patient Protection and Affordable Care Act for the 2014 – 2018 benefit years, pending further explanation of CMS’s reasons for operating the program in a budget neutral manner in those years.
On April 27, 2018, the Centers for Medicare & Medicaid Services issued a rule proposing updates for fiscal year 2019 to Medicare payment policies and rates for the Inpatient Psychiatric Facilities Prospective Payment System and the IPF Quality Reporting Program.
On April 27, 2018, the Centers for Medicare & Medicaid Services issued a proposed rule (CMS-1692-P) that would update fiscal year 2019 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.
The proposed HHS Notice of Benefit and Payment Parameters for 2018 released today proposes standards for issuers and each Health Insurance Marketplace, generally for plan years that begin on or after January 1, 2018.
On June 20, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking outlining proposed changes to the Payment Error Rate Measurement (PERM) and Medicaid Eligibility Quality Control (MEQC) programs to implement provisions in the Affordable Care Act’s changes to the way states adjudicate eligibility for Medicaid and the Children’s Health Insurance Program (CHIP).
The Centers for Medicare & Medicaid Services (CMS) has published a final rule that requires Medicare Parts A and B health care providers and suppliers to report and return overpayments by the later of the date that is 60 days after the date an overpayment was identified, or the due date of any corresponding cost report, if applicable.
On December 3, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that will improve CMS’ ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare.
On Oct. 31, 2014 the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2015.