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 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 - Chip Program - Medicaid Program and Children's Health Insurance Program - Changes to Medicaid Eligibility Quality Control and Payment Error (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid - Chip Program - Medicaid Program and Children's Health Insurance Program - Changes to Medicaid Eligibility Quality Control and Payment Error (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: 72

ISBN-13: 9781721523290

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Medicaid - CHIP Program - Medicaid Program and Children's Health Insurance Program - Changes to Medicaid Eligibility Quality Control and Payment Error (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid - CHIP Program - Medicaid Program and Children's Health Insurance Program - Changes to Medicaid Eligibility Quality Control and Payment Error (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule updates the Medicaid Eligibility Quality Control (MEQC) and Payment Error Rate Measurement (PERM) programs based on the changes to Medicaid and the Children's Health Insurance Program (CHIP) eligibility under the Patient Protection and Affordable Care Act. This rule also implements various other improvements to the PERM program. This book contains: - The complete text of the Medicaid - CHIP Program - Medicaid Program and Children's Health Insurance Program - Changes to Medicaid Eligibility Quality Control and Payment Error (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid and Children's Health Insurance Program (Chip) Programs - Medicaid Managed Care, Chip Delivered in Managed Care (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid and Children's Health Insurance Program (Chip) Programs - Medicaid Managed Care, Chip Delivered in Managed Care (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: 742

ISBN-13: 9781721535354

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Medicaid and Children's Health Insurance Program (CHIP) Programs - Medicaid Managed Care, CHIP Delivered in Managed Care (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid and Children's Health Insurance Program (CHIP) Programs - Medicaid Managed Care, CHIP Delivered in Managed Care (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule modernizes the Medicaid managed care regulations to reflect changes in the usage of managed care delivery systems. The final rule aligns, where feasible, many of the rules governing Medicaid managed care with those of other major sources of coverage, including coverage through Qualified Health Plans and Medicare Advantage plans; implements statutory provisions; strengthens actuarial soundness payment provisions to promote the accountability of Medicaid managed care program rates; and promotes the quality of care and strengthens efforts to reform delivery systems that serve Medicaid and CHIP beneficiaries. It also ensures appropriate beneficiary protections and enhances policies related to program integrity. This final rule also implements provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) and addresses third party liability for trauma codes. This book contains: - The complete text of the Medicaid and Children's Health Insurance Program (CHIP) Programs - Medicaid Managed Care, CHIP Delivered in Managed Care (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Program - Cost Limit for Providers Operated by Units of Government and Provisions to Ensure the Integrity of Federal-State Financial Partners (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program - Cost Limit for Providers Operated by Units of Government and Provisions to Ensure the Integrity of Federal-State Financial Partners (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: 168

ISBN-13: 9781721523801

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Medicaid Program - Cost Limit for Providers Operated by Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partners (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program - Cost Limit for Providers Operated by Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partners (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This regulation clarifies that entities involved in the financing of the non-Federal share of Medicaid payments must be a unit of government; clarifies the documentation required to support a Medicaid certified public expenditure; limits Medicaid reimbursement for health care providers that are operated by units of government to an amount that does not exceed the health care provider's cost of providing services to Medicaid individuals; requires all health care providers to receive and retain the full amount of total computable payments for services furnished under the approved Medicaid State plan; and makes conforming changes to provisions governing the State Child Health Insurance Program (SCHIP) to make the same requirements applicable, with the exception of the cost limit on reimbursement. This book contains: - The complete text of the Medicaid Program - Cost Limit for Providers Operated by Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partners (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Children's Health Insurance Program (Chip) - Allotment Methodology and State's Fiscal Years 2009 Through 2015 Chip Allotments (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Children's Health Insurance Program (Chip) - Allotment Methodology and State's Fiscal Years 2009 Through 2015 Chip Allotments (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: 32

ISBN-13: 9781720990871

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Children's Health Insurance Program (CHIP) - Allotment Methodology and State's Fiscal Years 2009 through 2015 CHIP Allotments (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Children's Health Insurance Program (CHIP) - Allotment Methodology and State's Fiscal Years 2009 through 2015 CHIP Allotments (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule describes the implementation of funding provisions under Title XXI of the Social Security Act (the Act), for the Children's Health Insurance Program (CHIP), as amended by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), by other related CHIP legislation, and most recently by the Patient Protection and Affordable Care Act of 2010 (the Affordable Care Act). Specifically, this final rule addresses methodologies and procedures for determining States' fiscal years 2009 through 2015 allotments and payments in accordance with sections 2104 and 2105 of the Act, as amended by CHIPRA and the Affordable Care Act. This book contains: - The complete text of the Children's Health Insurance Program (CHIP) - Allotment Methodology and State's Fiscal Years 2009 through 2015 CHIP Allotments (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

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

Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update, Cy 2015 - Home Health Quality Reporting Requirements (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update, Cy 2015 - Home Health Quality Reporting Requirements (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: 148

ISBN-13: 9781722463359

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Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update, CY 2015 - Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update, CY 2015 - Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model. This book contains: - The complete text of the Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update, CY 2015 - Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update for Cy 2014, Home Health Quality Reporting Requirements (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update for Cy 2014, Home Health Quality Reporting Requirements (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: 120

ISBN-13: 9781722463304

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Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule will update the Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, the low-utilization payment adjustment (LUPA) add-on, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective January 1, 2014. As required by the Affordable Care Act, this rule establishes rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode payment rates; the national per-visit rates; and the NRS conversion factor. In addition, this final rule will remove 170 diagnosis codes from assignment to diagnosis groups within the HH PPS Grouper, effective January 1, 2014. Finally, this rule will establish home health quality reporting requirements for CY 2014 payment and subsequent years and will clarify that a state Medicaid program must provide that, in certifying HHAs, the state's designated survey agency carry out certain other responsibilities that already apply to surveys of nursing facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID), including sharing in the cost of HHA surveys. For that portion of costs attributable to Medicare and Medicaid, we will assign 50 percent to Medicare and 50 percent to Medicaid, the standard method that CMS and states use in the allocation of expenses related to surveys of nursing homes. This book contains: - The complete text of the Medicare and Medicaid Programs - Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section