CMS

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New GAO Study Finds Opportunities To Improve CMS Use Of Medicare Pre-Pay Edits

Posted on by Frank J. Rosello

Use of prepayment edits saved Medicare at least $1.76 billion in fiscal year 2010, but a new study by the Government Accountability Office found that savings could have been greater had the edits been more widely used. According to GAO, … Continue reading

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CMS Counting On Technology To Revamp Medicaid

Posted on by Frank J. Rosello

The Medicaid expansion was supposed to be the least controversial part of the health reform lawsuit. But since the Supreme Court essentially made broadening its eligibility voluntary for states, not a day goes by without news reports guessing how Medicaid … Continue reading

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CMS Issues Proposed Rule On Policy And Payment Changes For Outpatient Care

Posted on by Frank J. Rosello

On Friday, July 6,2012, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update many payment policies and rates involving services for Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning … Continue reading

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CMS Administrator Credits Health Reform For Advancing ACOs

Posted on by Frank J. Rosello

If it weren’t for the Affordable Care Act (ACA), the government would not have had the framework and authority to help support the movement toward accountable care organizations, said Marilyn Tavenner, acting administrator for the Centers for Medicare & MedicaidServices … Continue reading

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CMS Rule Targets Medicare Fraud As GAO Says More Could Be Done

Posted on by Frank J. Rosello

Even as the Centers for Medicare & Medicaid Services (CMS) announced a final rule Tuesday, April 24th aimed at preventing Medicare fraud and saving taxpayers nearly $1.6 billion over 10 years, the GAO came out with a report urging CMS … Continue reading

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CMS Launches (esMD) Pilot

Posted on by Frank J. Rosello

CMS intends to give providers a new mechanism for submitting medical documentation. CMS calls this new mechanism the Electronic Submission of Medical Documentation (esMD) pilot. During Phase 1 of esMD, Providers will still receive medical documentation requests via paper mail … Continue reading

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