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Friday, 09 October 2009 |
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On Friday, September 25, 2009, the Department of Health and Human Services (DHHS) published in the Federal Register the threshold amounts for filing Medicare appeals for calendar year 2010. Every year, the amount in controversy (AIC) limit increases. This year’s increase is effective for Administrative Law Judge (ALJ) hearings and Judicial Reviews filed on or after January 1, 2010. Read full article.
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Friday, 09 October 2009 |
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On September 14, 2009, the Centers for Medicare and Medicaid Services (CMS) issued a correction notice which changes FR&R’s Healthcare Bulletin HC 2009-37 Revalidation Process for Skilled Nursing Facilities, Physicians, and Organizational Suppliers.
Providers who do not have an enrollment record in the Provider Enrollment Chain and Ownership System (PECOS) will be targeted for this first round of revalidation. Having an Electronic Funds Transfer (EFT) will no longer be a factor in the revalidation selection process. Read full article.
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Friday, 09 October 2009 |
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Through the Deficit Reduction Act of 2005, the Centers for Medicare and Medicaid Services (CMS) was authorized to launch the Medicaid Integrity Program (MIP). According to the 2008 Government Accountability Office (GAO) report, the Medicaid program was the federally funded program that had the highest amount of improper payments in 2007 ($12.9 billion dollars). Read full article.
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Friday, 09 October 2009 |
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On September 13, 2009, the Centers for Medicare & Medicaid Services (CMS) enacted two new security procedures for the National Plan and Provider Enumerator System (NPPES). In addition, the Electronic File Interchange (EFI) User Manual and Technical Companion Guide has also been revised. The new security procedures do not change the EFI Extensible Markup Language (XML) schema. Read full article.
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Wednesday, 07 October 2009 |
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Effective October 5, 2009, providers will no longer be able to submit Medicare Secondary Payer (MSP) and conditional claims via Fiscal Intermediary Standard System Direct Data Entry (FISS/DDE). All MSP and conditional claims will need to be submitted electronically (on the 837I) or, if applicable, on a UB-04 (CMS-1450) paper claim form. Read full article.
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