[07/08/25]
Posted on July 8, 2025 in Health Law News
Published by: Hall Render
On June 27, 2025, the Center for Medicare & Medicaid Innovation (“CMMI”) announced the Wasteful and Inappropriate Service Reduction (“WISeR”) Model, its latest model focused on reducing clinically inappropriate and low-value services in traditional Medicare. Unlike prior CMMI models, WISeR stands out for its exclusion of traditional health care providers, such as hospitals and... READ MORE
Tags: Center for Medicare & Medicaid Innovation, CMMI, medicare administrative contractor, WISeR Model
[10/25/19]
Posted on October 25, 2019 in Health Law News
Published by: Hall Render
Recently, hospitals operating nursing and other allied health (“N&AH”) education programs have experienced increased scrutiny during Medicare Administrative Contractor (“MAC”) audits concerning their receipt of pass-through cost reimbursement. In many instances, MACs have begun disallowing or reclassifying costs that N&AH education programs received without issue for many years. Oftentimes the MACs are citing new... READ MORE
Tags: Allied Health Education Programs, MAC, medicare administrative contractor, Nursing and allied health, reimbursement
[08/10/11]
Posted on August 10, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
As of March 2011, the Centers for Medicare & Medicaid Services (CMS) implemented new screening criteria in the Medicare provider/supplier enrollment process. Newly enrolling and revalidating providers and suppliers are placed in one of three categories – limited, moderate, or high – each representing the level of risk to the Medicare program for that... READ MORE
Tags: 60 day, 6401a, ACA, accountable care, application, billing, bufford, categories, centers for medicare & medicaid, centers for medicare and medicaid, cms, deactivation, enrollment, fee, high, Home Health, Hospice, jent, limited, long term care, MAC, march, march 25, Medicaid/Medicare Enrollment and Regulatory Compliance, Medicare, medicare administrative contractor, moderate, pay.gov, pecos, process, provider, revalidation, risk, screening, selby, supplier
