Monday, October 19th, 2009
Carriers and Part A and Part B Medicare Administrative Contractors (A/B MACs) are creating lists and checking them twice, but they’re not looking for who’s been naughty or nice. On these lists are X-ray suppliers currently billing Medicare who are not in the Provider Enrollment, Chain, and Ownership System (PECOS). Read more »
Monday, October 5th, 2009
Connolly Healthcare, recovery audit contractor (RAC) for region C, recently updated its list of audit issues approved by the Centers for Medicare & Medicaid Services (CMS) and DCS Healthcare, region A RAC, posted new issues for the first time. The lists of issues under review give providers insight into what they should be looking for in their own internal audits. Read more »
Monday, October 5th, 2009
The Centers for Medicare & Medicaid Services (CMS) issued, Sept. 25, new guidance that delegates Medicare contractors the authority to make an exception to clinical criteria described in a local coverage determination (LCD) on a case-by-case basis and even reconsider an LCD if evidence upholds necessity. Read more »
Monday, August 3rd, 2009
The rapid increase of ultrasound services nationwide has Medicare watchdogs on the alert. Health care practitioners who submit Part B claims for technical and professional ultrasound services can expect added scrutiny. A recent Office of Inspector General (OIG) report provides insight as to what Medicare Administrative Contractors (MACs) will soon be on the lookout for when reviewing imaging service claims.
Monday, June 29th, 2009
The Centers for Medicare & Medicaid Services (CMS) has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC). The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours to prevent a gap in Medicare payments. The fax may have the CMS logo and/or the Medicare contractor logo to enhance the appearance of authenticity.
Tuesday, May 12th, 2009
Noridian Administrative Services, LLC (NAS) announced earlier this month that it is retiring certain local coverage determinations (LCDs) and revising a few others.
Wednesday, February 11th, 2009
The Centers for Medicare & Medicaid Services (CMS) announced Feb. 6 that the permanent Recovery Audit Contractor (RAC) program is set to begin March 1. The bidding protests filed by Viant, Inc. and PRG Schultz, USA, Inc., which caused a Stop Work order in October 2008, are resolved.
Friday, January 16th, 2009
The Centers for Medicare & Medicaid Services (CMS) announced Jan. 7 it has awarded five Medicare Administrative Contractor (MAC) contracts for the combined administration of Part A and Part B Medicare fee-for-service (FFS) claims.
Monday, January 5th, 2009
The Centers for Medicare & Medicaid Services (CMS) launched its fourth annual health care provider satisfaction survey. Approximately 30,000 providers nationwide were randomly selected to participate in the Medicare Contractor Provider Satisfaction Survey (MCPSS) where they’ll reflect on their experiences with federal payers. Selected participants were to receive an invitation by the first of the year.
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