CMS Transitions Administrative Functions for HHA Enrollments and CHOWs

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 12749 that describes the transitioning of certain certification enrollment functions performed by the CMS Survey and Operations Group (SOG) Locations (formerly CMS Regional Offices) to CMS’ Center for Program Integrity (CPI) Provider Enrollment Oversight Group (PEOG) and the Medicare Administrative Contractors (MACs). To…

CMS to Proceeed with Targeted Probe and Educate

The Centers for Medicare & Medicaid Services (CMS) has decided to continue to proceed with the Targeted Probe and Educate (TPE) medical review, which they resumed on September 1, 2021. (Please see NAHC Report CMS Resumes Targeted Probe & Educate.) Although, the Medicare Administrative Contractors (MACs) have been conducting limited medical review since August 2020, a…

NAHC Business Partner Members: CMS Holding Forum About Developing Medicare Fee for Service Documentation Requirement Lookup Service Prototype

The Centers for Medicare & Medicaid Services, Center for Program Integrity will host a series of SODF calls to educate the public about a new initiative underway to develop a Medicare Fee for Service (FFS) Documentation Requirement Lookup Service prototype. Also, to allow physicians, suppliers, IT and Electronic Health Record (EHR) Developers and Vendors, and/or…

Key House Panel Takes Aim at Medicare Fraud

Declaring there is “too much” fraud in Medicare payments, members of a key House of Representatives subcommittee vowed to attack the problem and called witnesses to suggest various means of doing so. On Tuesday, July 17th, the Oversight Subcommittee of the House of Representatives Ways and Means Committee held a hearing titled, Combating Fraud in…