Medicaid Program - Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program - Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (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: 56

ISBN-13: 9781721524563

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Medicaid Program - Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program - Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule will revise Medicaid regulations for Mechanized Claims Processing and Information Retrieval Systems. We are also modifying our regulations so that the enhanced Federal financial participation (FFP) is available for design, development and installation or enhancement of eligibility determination systems until December 31, 2015. This final rule also imposes certain defined standards and conditions in terms of timeliness, accuracy, efficiency, and integrity for mechanized claims processing and information retrieval systems in order to receive enhanced FFP. This book contains: - The complete text of the Medicaid Program - Federal Funding for Medicaid Eligibility Determination and Enrollment Activities (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Eligibility Changes Under Affordable Care ACT (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Eligibility Changes Under Affordable Care ACT (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-06-11

Total Pages: 160

ISBN-13: 9781721058945

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Eligibility Changes under Affordable Care Act (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Eligibility Changes under Affordable Care Act (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of Affordable Insurance Exchanges ("Exchanges"), and the assurance of coordination between Medicaid, CHIP, and Exchanges. This final rule codifies policy and procedural changes to the Medicaid and CHIP programs related to eligibility, enrollment, renewals, public availability of program information and coordination across insurance affordability programs. This book contains: - The complete text of the Eligibility Changes under Affordable Care Act (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicaid Program - Elimination of Reimbursement Under Medicaid for School Administration Expenditures (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program - Elimination of Reimbursement Under Medicaid for School Administration Expenditures (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: 34

ISBN-13: 9781721524396

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Medicaid Program - Elimination of Reimbursement Under Medicaid for School Administration Expenditures (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program - Elimination of Reimbursement Under Medicaid for School Administration Expenditures (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 Under the Medicaid program, Federal payment is available for the costs of administrative activities "as found necessary by the Secretary for the proper and efficient administration of the State plan." This final rule eliminates Federal Medicaid payment for the costs of certain school-based administrative and transportation activities because the Secretary has found that these activities are not necessary for the proper and efficient administration of the Medicaid State plan and are not within the definition of the optional transportation benefit. Based on these determinations, under this final rule, Federal Medicaid payments will no longer be available for administrative activities performed by school employees or contractors, or anyone under the control of a public or private educational institution, and for transportation from home to school. In addition, this final rule responds to public comments received on the September 7, 2007 proposed rule. This book contains: - The complete text of the Medicaid Program - Elimination of Reimbursement Under Medicaid for School Administration Expenditures (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 Programs - Fair Hearing and Appeal Processes for Medicaid (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid and Children's Health Insurance Programs - Fair Hearing and Appeal Processes for Medicaid (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: 192

ISBN-13: 9781721535422

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Medicaid and Children's Health Insurance Programs - Fair Hearing and Appeal Processes for Medicaid (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 Programs - Fair Hearing and Appeal Processes for Medicaid (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Affordable Care Act that expand access to health coverage through improvements in Medicaid and coordination between Medicaid, CHIP, and Exchanges. This rule finalizes most of the remaining provisions from the "Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans, Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid and Exchange Eligibility Appeals and Other Provisions Related to Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing; Proposed Rule" that we published in the January 22, 2013, Federal Register. This final rule continues our efforts to assist states in implementing Medicaid and CHIP eligibility, appeals, and enrollment changes required by the Affordable Care Act. This book contains: - The complete text of the Medicaid and Children's Health Insurance Programs - Fair Hearing and Appeal Processes for Medicaid (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

Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, Etc. (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, Etc. (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: 32

ISBN-13: 9781722458553

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Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, etc. (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, etc. (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This interim final rule with comment period implements several provisions set forth in the Patient Protection and Affordable Care Act (Affordable Care Act). It implements the provision which requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs. This interim final rule with comment period also requires physicians and eligible professionals to order and refer covered items and services for Medicare beneficiaries to be enrolled in Medicare. In addition, it adds requirements for providers, physicians, and other suppliers participating in the Medicare program to provide documentation on referrals to programs at high risk of waste and abuse, to include durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), home health services, and other items or services specified by the Secretary. This book contains: - The complete text of the Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements, etc. (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

Health Care Fraud and Abuse
Health Care Fraud and Abuse

Author: Aspen Health Law Center

Publisher:

Published: 1998

Total Pages: 156

ISBN-13:

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Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.

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

Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation 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: 76

ISBN-13: 9781722458393

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Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation 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 - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule finalizes several provisions of the Affordable Care Act implemented in the May 5, 2010 interim final rule with comment period. It requires all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted under the Medicare and Medicaid programs. In addition, it requires physicians and other professionals who are permitted to order and certify covered items and services for Medicare beneficiaries to be enrolled in Medicare. Finally, it mandates document retention and provision requirements on providers and supplier that order and certify items and services for Medicare beneficiaries. This book contains: - The complete text of the Medicare and Medicaid Programs - Changes in Provider and Supplier Enrollment, Ordering and Referring, and Documentation Requirements (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section