On March 18, 2010, House Speaker Nancy Pelosi posted a copy of the 153 page Health Care and Education Affordability Reconciliation Act of 2010 (H.R.4872) on her website . On her website , House Speaker Pelosi has also posted a Summary and Section-By-Section Analysis of H.R.4872 and a document pointing out reported improvements to the Senate health care reform bill (H.R.3590). A number of news organizations report that the House may vote on H.R.4872... 

The Centers for Medicare & Medicaid Services (CMS) recently released a revised Medicare Fraud & Abuse Fact Sheet (February 2010). According to CMS, this fact sheet identifies sources of information pertaining to Medicare fraud and abuse and helps one understand what to do if one suspects or becomes aware of incidents of potential fraud and abuse. Subscribe to Medicare Update, follow me on Twitter @MedicareUpdate , and become a fan on... 

On March 17, 2010, the Centers for Medicare & Medicaid Services (CMS) posted a new Frequently Asked Question (FAQ) on the Medicare  Recovery Audit Contractor (RAC) Program . The new FAQ addresses the RAC discussion period and the rebuttal and redetermination process. The new FAQ and related link is set forth below: What is the difference between the Recovery Audit Contractor (RAC) discussion period and the Rebuttal and Redetermination process?... 

The Centers for Medicare & Medicaid Services (CMS) recently released a new fact sheet entitled ” The Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program – A Better Way for Medicare to Pay for Medical Equipment ” (February 2010).  According to CMS, this fact sheet gives providers and suppliers an overview of the DMEPOS Competitive Bidding Program and information regarding the... 

The Centers for Medicare & Medicaid Services (CMS) recently released a revised Clinical Laboratory Fee Schedule Fact Sheet (January 2010), which provides general information about the Clinical Laboratory Fee Schedule, coverage of clinical laboratory services, and how payment rates are set. Subscribe to Medicare Update, follow me on Twitter @MedicareUpdate , and become a fan on Facebook .  Read More →

As previously reported, the Final Rule updating the Medicare home health prospective payment system for calendar year 2010 modified the Medicare regulations regarding ownership changes. Specifically, the Centers for Medicare & Medicaid Services (CMS) amended 42 C.F.R. §424.550(b) by adding paragraph (b)(1), which states: (1) If an owner of a home health agency sells (including asset sales or stock transfers), transfers or relinquishes ownership... 

On March 11, 2010, the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) released its Compendium of Unimplemented Office of Inspector General Recommendations (March 2010). The Compendium includes information about OIG recommendations that had not been fully implemented as of September 30, 2009.  The Compendium also includes a list of “priority recommendations,” which the OIG believes represent the... 

On March 10, 2010, the U.S. Senate passed legislation (H.R.4213) on a 62-36 vote , which would reportedly delay a scheduled 21.2 percent Medicare payment reduction for physician services until October 1, 2010. In the Final Rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year 2010, CMS adopted an update of -21.2 percent. MPFS rates are updated annually based on a formula that includes the sustainable growth rate (SGR) formula. ... 

On March 10, 2010, President Obama announced in a Press Release that new efforts will be undertaken to “crack down on waste and fraud in Medicare, Medicaid, and other government programs through the expanded use of payment recapture audits.” According to the Press Release , President Obama will sign a presidential memorandum today that directs all federal departments and agencies to expand and intensify their use of payment recapture... 

On March 10, 2010, President Obama announced in a Press Release that new efforts will be undertaken to “crack down on waste and fraud in Medicare, Medicaid, and other government programs through the expanded use of payment recapture audits.” According to the Press Release , President Obama will sign a presidential memorandum today that directs all federal departments and agencies to expand and intensify their use of payment recapture... 

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will hold a “Basic Introduction to ICD-10-CM National Provider Conference Call” on March 23, 2010. The conference call will take place from 1:00 p.m. – 2:30 p.m. (EDT) and provide an overview of ICD-10-CM/PCS requirements and a basic introduction to ICD-10-CM.  According to CMS, the topics to be discussed include: Requirement to report ICD-10-CM/PCS... 

The Centers for Medicare & Medicaid Services (CMS) is reminding interested parties that on March 15, 2010 the comment period closes on the Proposed Rule , which would implement an electronic health records (EHR) incentive program for eligible professionals and eligible hospitals that adopt and meaningfully use certified EHR technology. According to CMS, comments may be submitted electronically through http://www.regulations.gov . See the Proposed... 

On March 4, 2010, the Inspector General for the Department of Health and Human Services (OIG) testified before the House Appropriations Committee’s Subcommittee on Labor, Health and Human Services, Education and Related Agencies on Medicare fraud, waste and abuse. In written testimony , the OIG points out that the President’s budget for FY 2011 proposes an additional $65 million increase in Health Care Fraud and Abuse Control program... 

On March 3, 2010, Representative Peter Welch and 61 House members introduced the Medicare Prescription Drug Price Negotiation Act of 2010 (H.R.4752). H.R.4752 is reportedly based on an amendment sponsored by Representative Welch that was included in the House passed Affordable Health Care for America Act (H.R.3962).  Among other things, H.R.4752 would require that the Secretary of the Department of Health and Human Services negotiate with pharmaceutical... 

On March 3, 2010, a representative of the Department of Health and Human Services’ Office of Inspector General (OIG) testified before the Senate Committee on Homeland Security and Governmental Affairs regarding oversight challenges in the Medicare Part D prescription drug program. In the OIG’s written testimony , the OIG stated (in part) the following regarding the Centers for Medicare & Medicaid Services ‘ (CMS) oversight...