Medicaid and Childrens Health Insurance Programs - Disallowance of Claims for Ffp and Technical Corrections (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid and Childrens Health Insurance Programs - Disallowance of Claims for Ffp and Technical Corrections (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-16

Total Pages: 40

ISBN-13: 9781721535507

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Medicaid and Childrens Health Insurance Programs - Disallowance of Claims for FFP and Technical Corrections (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid and Childrens Health Insurance Programs - Disallowance of Claims for FFP and Technical Corrections (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule reflects the Centers for Medicare & Medicaid Services' commitment to the general principles of the President's Executive Order 13563 released January 18, 2011, entitled "Improving Regulation and Regulatory Review." This rule will: implement a new reconsideration process for administrative determinations to disallow claims for Federal financial participation (FFP) under title XIX of the Act (Medicaid); lengthen the time States have to credit the Federal government for identified but uncollected Medicaid provider overpayments and provide that interest will be due on amounts not credited within that time period; make conforming changes to the Medicaid and Children's Health Insurance Program (CHIP) disallowance process to allow States the option to retain disputed Federal funds through the new administrative reconsideration process; revise installment repayment standards and schedules for States that owe significant amounts; and provide that interest charges may accrue during the new administrative reconsideration process if a State chooses to retain the funds during that period. This final rule will also make a technical correction to reporting requirements for disproportionate share hospital payments, revise internal delegations of authority to reflect the term "Administrator or current Designee," remove obsolete language, and correct other technical errors. This book contains: - The complete text of the Medicaid and Childrens Health Insurance Programs - Disallowance of Claims for FFP and Technical Corrections (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Program and Childrens Health Insurance Program - Revisions to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program and Childrens Health Insurance Program - Revisions to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-16

Total Pages: 86

ISBN-13: 9781721533817

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Medicaid Program and Childrens Health Insurance Program - Revisions to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program and Childrens Health Insurance Program - Revisions to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions from the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) (Pub. L. 111-3) with regard to the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs. This final rule also codifies several procedural aspects of the process for estimating improper payments in Medicaid and the Children's Health Insurance Program (CHIP). This book contains: - The complete text of the Medicaid Program and Childrens Health Insurance Program - Revisions to the Medicaid Eligibility Quality Control and Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Program and State Childrens Health Insurance Program (Schip) Payment Error Rate Measurement (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program and State Childrens Health Insurance Program (Schip) Payment Error Rate Measurement (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-16

Total Pages: 42

ISBN-13: 9781721534012

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Medicaid Program and State Childrens Health Insurance Program (SCHIP) Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program and State Childrens Health Insurance Program (SCHIP) Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This interim final rule sets forth the State requirements to provide information to us for purposes of estimating improper payments in Medicaid and the State Children's Health Insurance Program (SCHIP), as required under the Improper Payments Information Act (IPIA) of 2002. The IPIA requires heads of Federal agencies to annually estimate and report to the Congress these estimates of improper payments for the programs they oversee and, submit a report on actions the agency is taking to reduce erroneous payments. We published a proposed rule on August 27, 2004 to propose that States measure improper payments in Medicaid and SCHIP and report the State-specific error rates to us for purposes of computing the improper payment estimates for these programs. This book contains: - The complete text of the Medicaid Program and State Childrens Health Insurance Program (SCHIP) Payment Error Rate Measurement (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Programs - Payment Adjustment for Provider Preventable Conditions Including Health Care Acquired Conditions (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Programs - Payment Adjustment for Provider Preventable Conditions Including Health Care Acquired Conditions (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-16

Total Pages: 52

ISBN-13: 9781721535323

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Medicaid Programs - Payment Adjustment for Provider Preventable Conditions Including Health Care Acquired Conditions (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Programs - Payment Adjustment for Provider Preventable Conditions Including Health Care Acquired Conditions (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule will implement section 2702 of the Patient Protection and Affordable Care Act which directs the Secretary of Health and Human Services to issue Medicaid regulations effective as of July 1, 2011 prohibiting Federal payments to States under section 1903 of the Social Security Act for any amounts expended for providing medical assistance for health care-acquired conditions specified in the regulation. It will also authorize States to identify other provider-preventable conditions for which Medicaid payment will be prohibited. This book contains: - The complete text of the Medicaid Programs - Payment Adjustment for Provider Preventable Conditions Including Health Care Acquired Conditions (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Civil Monetary Penalties (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Civil Monetary Penalties (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-09

Total Pages: 62

ISBN-13: 9781720991809

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Civil Monetary Penalties (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Civil Monetary Penalties (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 The Department of Health and Human Services (HHS) is issuing a new regulation to adjust for inflation the maximum civil monetary penalty amounts for the various civil monetary penalty authorities for all agencies within HHS. We are taking this action to comply with the Federal Civil Penalties Inflation Adjustment Act of 1990 (the Inflation Adjustment Act), as amended by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. In addition, this interim final rule includes updates to certain agency-specific regulations to identify their updated information, and note the location of HHS-wide regulations. This book contains: - The complete text of the Civil Monetary Penalties (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare Program - Inpatient Rehabilitation Facility Prospective Payment System (2007 Fy) (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare Program - Inpatient Rehabilitation Facility Prospective Payment System (2007 Fy) (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-07-05

Total Pages: 132

ISBN-13: 9781722466138

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Medicare program - Inpatient rehabilitation facility prospective payment system (2007 FY) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare program - Inpatient rehabilitation facility prospective payment system (2007 FY) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule will update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2007 (for discharges occurring on or after October 1, 2006 and on or before September 30, 2007) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). This book contains: - The complete text of the Medicare program - Inpatient rehabilitation facility prospective payment system (2007 FY) (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries who Received Services During 2009 Through 2011
Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries who Received Services During 2009 Through 2011

Author:

Publisher:

Published: 2013

Total Pages:

ISBN-13:

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Pursuant to Title XVIII of the Social Security Act, the Medicare program provides health insurance for people aged 65 and over, people with disabilities, and people with permanent kidney disease. The Centers for Medicare & Medicaid Services (CMS), which administers the program, contracts with Medicare contractors to process and pay Medicare Part A and Part B claims submitted by health care providers. Under Federal requirements, Medicare generally does not pay for services rendered to incarcerated beneficiaries. Federal requirements, however, allow Medicare payment if State or local law requires incarcerated beneficiaries to repay the cost of medical services. Health care providers indicate this exception by placing a specific code on the claims submitted for payment. We refer to this code as "exception code." The Social Security Administration (SSA) is CMS's primary source of information about incarcerated beneficiaries. Generally, SSA collects information, such as the names of beneficiaries and the dates on which beneficiaries begin and/or end periods of incarceration, directly from penal authorities. SSA also collects incarceration end dates from beneficiaries' requests for reinstatement of Social Security benefits. CMS's records identified 135,805 Medicare beneficiaries who had been incarcerated at some point during calendar years (CY) 2009 through 2011. We limited our review to 75,639 claims on behalf of 11,619 incarcerated beneficiaries with $33,587,634 in associated Medicare payments.

Medicare - Inpatient Psychiatric Facilities Prospective Payment System (2007 Ry) - Update (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare - Inpatient Psychiatric Facilities Prospective Payment System (2007 Ry) - Update (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-16

Total Pages: 198

ISBN-13: 9781721535767

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Medicare - Inpatient psychiatric facilities prospective payment system (2007 RY) - update (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare - Inpatient psychiatric facilities prospective payment system (2007 RY) - update (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes are applicable to IPF discharges occurring during the rate year beginning July 1, 2006 through June 30, 2007. In addition, we are adopting the new Office of Management and Budget (OMB) labor market area definitions for the purpose of geographic classification and the wage index. We are also making revisions to existing policies and implementing new polices. This book contains: - The complete text of the Medicare - Inpatient psychiatric facilities prospective payment system (2007 RY) - update (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Expansion
Medicaid Expansion

Author: United States. Government Accountability Office

Publisher:

Published: 2012

Total Pages: 38

ISBN-13:

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The Patient Protection and Affordable Care Act (PPACA), signed into law on March 23, 2010, made significant changes to the way eligibility for the Medicaid program will be determined and who the program will cover. Under PPACA, eligibility for Medicaid--a joint federal-state program that finances health care for certain categories of low-income individuals--must be expanded to non-elderly individuals with incomes at or below 133 percent of the federal poverty level (FPL) beginning on January 1, 2014. Through this expansion, states will provide Medicaid coverage to eligible low-income parents and childless adults. PPACA also requires the establishment of American Health Benefit Exchanges (referred to as exchanges)--marketplaces where eligible individuals can purchase private health insurance in each state. The Centers for Medicare & Medicaid Services' (CMS) Office of the Actuary has estimated that, as a result of the expansion, the number of Medicaid enrollees will increase by 14.9 million in 2014 and by 25.9 million in 2020. State governments will play a key role in implementing many aspects of this reform, which must be in place by the beginning of 2014. Specifically, states will need to make major changes to the way they conduct Medicaid eligibility determinations for individuals and families. States also will need to develop streamlined eligibility and enrollment systems that allow for the coordination of enrollment across Medicaid, the Children's Health Insurance Program (CHIP), and exchanges. At the same time, states will need to address the financial implications of implementing this Medicaid expansion and accompanying enrollment systems. The federal government will initially provide states with full funding to cover the cost of adults who are newly eligible for Medicaid due to the expansion. Congress asked us to report on the actions states are taking to implement the Medicaid expansion. This report addresses the following questions: 1. What are states' responsibilities for implementing the Medicaid expansion provisions under PPACA? 2. What actions have selected states taken to prepare for the Medicaid expansion provisions of PPACA and what challenges have they encountered? 3. What are states' views on the fiscal implications of the Medicaid expansion on state budget planning?