Medicaid Program - Rescission of School-Based Administration - Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescis (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicaid Program - Rescission of School-Based Administration - Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescis (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: 32

ISBN-13: 9781721527434

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Medicaid Program - Rescission of School-Based Administration - Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescis (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program - Rescission of School-Based Administration - Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescis (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This rule finalizes our proposal to rescind the December 28, 2007 final rule entitled, "Elimination of Reimbursement under Medicaid for School Administration Expenditures and Costs Related to Transportation of School-Age Children Between Home and School;" the November 7, 2008 final rule entitled, "Clarification of Outpatient Hospital Facility (Including Outpatient Hospital Clinic) Services Definition;" and certain provisions of the December 4, 2007 interim final rule entitled, "Optional State Plan Case Management Services." These regulations have been the subject of Congressional moratoria and have not yet been implemented (or, with respect to the case management interim final rule, have only been partially implemented) by CMS. In light of concerns raised about the adverse effects that could result from these regulations, in particular, the potential restrictions on services available to beneficiaries and the lack of clear evidence demonstrating that the approaches taken in the regulations are warranted, CMS is rescinding the two final rules in full, and partially rescinding the interim final rule. Rescinding these provisions will permit further opportunity to determine the best approach to further the objectives of the Medicaid program in providing necessary health benefits coverage to needy individuals. This book contains: - The complete text of the Medicaid Program - Rescission of School-Based Administration - Transportation Final Rule, Outpatient Hospital Services Final Rule, and Partial Rescis (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 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

Patient Protection and Affordablecare ACT - Program Integrity - Exchange, Shop, and Eligibility Appeals (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Patient Protection and Affordablecare ACT - Program Integrity - Exchange, Shop, and Eligibility Appeals (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: 164

ISBN-13: 9781722604646

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Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines Exchange standards with respect to eligibility appeals, agents and brokers, privacy and security, issuer direct enrollment, and the handling of consumer cases. It also sets forth standards with respect to a State's operation of the Exchange and Small Business Health Options Program (SHOP). It generally is finalizing previously proposed policies without change. This book contains: - The complete text of the Patient Protection and AffordableCare Act - Program Integrity - Exchange, SHOP, and Eligibility Appeals (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Patient Protection and Affordable Care ACT - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (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: 9781722601829

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Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule specifies additional options for annual eligibility redeterminations and renewal and re-enrollment notice requirements for qualified health plans offered through the Exchange, beginning with annual redeterminations for coverage for benefit year 2015. This final rule provides additional flexibility for Exchanges, including the ability to propose unique approaches that meet the specific needs of their state, while streamlining the consumer experience. This book contains: - The complete text of the Patient Protection and Affordable Care Act - Annual Eligibility Redeterminations for Exchange Participation and Insurance Affordability Programs (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Patient Protection and Affordable Care ACT - Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Patient Protection and Affordable Care ACT - Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (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: 24

ISBN-13: 9781722499815

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Patient Protection and Affordable Care Act - Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Patient Protection and Affordable Care Act - Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This interim final rule with comment establishes provisions that alter the parameters of select special enrollment periods and that revise certain rules governing consumer operated and oriented plans (CO-OPs). This book contains: - The complete text of the Patient Protection and Affordable Care Act - Amendments to Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare Program - Termination of Non-Random Prepayment Complex Medical Review (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Medicare Program - Termination of Non-Random Prepayment Complex Medical Review (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-07-04

Total Pages: 26

ISBN-13: 9781722432409

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Medicare Program - Termination of Non-Random Prepayment Complex Medical Review (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Termination of Non-Random Prepayment Complex Medical Review (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements requirements regarding the termination of non-random prepayment complex medical review as required under the Medicare Prescription Drug, Improvement and Modernization Act of 2003. This final rule sets forth the criteria CMS contractors will use for terminating a provider or supplier from non-random prepayment complex medical review. This book contains: - The complete text of the Medicare Program - Termination of Non-Random Prepayment Complex Medical Review (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

Medicare, Medicaid, and Children's Health Insurance Programs - Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria (Us Inspector General Office, Health and Human Services Department Regulation) (Hhsig) (2018 Edition)
Medicare, Medicaid, and Children's Health Insurance Programs - Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria (Us Inspector General Office, Health and Human Services Department Regulation) (Hhsig) (2018 Edition)

Author: The Law The Law Library

Publisher: Createspace Independent Publishing Platform

Published: 2018-11-09

Total Pages: 230

ISBN-13: 9781729716670

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Medicare, Medicaid, and Children's Health Insurance Programs - Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria (US Inspector General Office, Health and Human Services Department Regulation) (HHSIG) (2018 Edition) The Law Library presents the complete text of the Medicare, Medicaid, and Children's Health Insurance Programs - Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria (US Inspector General Office, Health and Human Services Department Regulation) (HHSIG) (2018 Edition). Updated as of May 29, 2018 This final rule with comment period will implement provisions of the ACA that establish: Procedures under which screening is conducted for providers of medical or other services and suppliers in the Medicare program, providers in the Medicaid program, and providers in the Children's Health Insurance Program (CHIP); an application fee imposed on institutional providers and suppliers; temporary moratoria that may be imposed if necessary to prevent or combat fraud, waste, and abuse under the Medicare and Medicaid programs, and CHIP; guidance for States regarding termination of providers from Medicaid and CHIP if terminated by Medicare or another Medicaid State plan or CHIP; guidance regarding the termination of providers and suppliers from Medicare if terminated by a Medicaid State agency; and requirements for suspension of payments pending credible allegations of fraud in the Medicare and Medicaid programs. This final rule with comment period also discusses our earlier solicitation of comments regarding provisions of the ACA that require providers of medical or other items or services or suppliers within a particular industry sector or category to establish compliance programs. This book contains: - The complete text of the Medicare, Medicaid, and Children's Health Insurance Programs - Additional Screening Requirements, Application Fees, Temporary Enrollment Moratoria (US Inspector General Office, Health and Human Services Department Regulation) (HHSIG) (2018 Edition) - A table of contents with the page number of each section

Medicaid and Outpatient Hospital Services
Medicaid and Outpatient Hospital Services

Author:

Publisher:

Published: 2009

Total Pages: 0

ISBN-13:

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On November 7, 2008, the Centers for Medicare and Medicaid Services (CMS) issued a final Medicaid rule on outpatient hospital services that excluded the proposed regulatory language delineating methods for demonstrating compliance with the upper payment limit on outpatient hospital services provided in private outpatient facilities. [...] The Proposed Rule on Outpatient Hospital Services Under Medicaid The proposed rule (72 Federal Register 55158, September 28, 2007) would limit the definition and scope of Medicaid outpatient services in a hospital clinic, hospital facility, or rural health clinic. [...] Under the proposed rule, the UPL for privately operated outpatient hospital facilities would remain tied to a reasonable estimate of what Medicare would pay for the same services. [...] Justification for the Proposed Rule CMS argues that the current definition of outpatient hospital services in regulations overlaps with other covered Medicaid benefits, so that identical services are sometimes paid a higher amount under the outpatient hospital benefit than would otherwise be available under other Medicaid benefit categories. [...] Specifically, the proposed OPH services rule incorporates the new definition of hospital categories that was adopted in the final rule regarding cost limits on public providers, which eliminates references to provider ownership status; commenters argue that including this language directly contravenes the moratorium on implementing any provision of the public provider rule.