Medical Review Resumes This Month

The Centers for Medicare & Medicaid Services (CMS) will resume medical revnew this month after originally delaying the program during the COVID-19 public health emergency (PHE). (NAHC Report originally reported this news on July 9.) On March 30, CMS suspended most Medicare Fee-For-Service (FFS) medical review because of the COVID-19 pandemic and, seemingly, for the…

CMS Updates Targeted Probe & Educate Information

The Centers for Medicare & Medicaid Services (CMS) published updated targeted probe and educate (TPE) information contained in Chapter 3 of the CMS Program Integrity Manual (Publication 100-08) through Transmittal 10132/Change Request (CR) 11695. The updates incorporate information about TPE practices providers have experienced, but were not clearly outlined in the Manual. This update includes…

Program Integrity Manual Updated for Identity Theft and Hospice Aggregate Cap Liability

The Centers for Medicare & Medicaid Services (CMS) recently released a new transmittal that updates the chapter of the Program Integrity Manual to address coordination between Medicare Administrative Contractors (MAC) and Unified Program Integrity Contractors (UPIC) in situations of hospice aggregate cap liabilities, as well as addressing Medicare liabilities in situations of provider identity theft.…

MAC Listening Sessions – Your Opportunity to Provide Feedback

The Centers for Medicare & Medicaid Services (CMS) is holding listening sessions to gather feedback and improve experience with the Medicare Fee-For-Service (FFS) program. This is your opportunity to provide feedback on your MAC – Medicare Administrative Contractor. For home health and hospice there are three MACs: Palmetto GBA, CGS, and NGS. Medicare Learning Network…

CMS Provides Direction to MACs on Use of Adjustment Codes

Via Transmittal 4415/Change Request (CR) 11113 – Medicare Administrative Contractor (MAC) Guidance Related to Use of Adjustment Codes on Adjustment Claims – the Centers for Medicare & Medicaid Services (CMS) directs the MACs to refine the claims adjustment reporting process to categorize adjustments by the origin of the adjustment request. The implementation date is January…

Please take this Quick Medicare Administrative Contractor Satisfaction Survey

The 2019 MAC Satisfaction Indicator (MSI), a survey administered by the Centers for Medicare & Medicaid Services (CMS), is now available. The MSI is designed to measure your satisfaction as a Medicare provider with the performance of your Medicare Administrative Contractor (MAC). This survey should only take 10 minutes of your time and helps the…

Education at Day 2 of the NAHC Conference Provides Insight Everyone in Home Health and Hospice Needs

A major reason why so many industry professionals came to the 2018 Home Health and Hospice Conference and Expo in Grapevine, Texas is the world class education that can be found nowhere else. Home Health Updates from Your MAC, CGS addressed recent and future changes in Medicare that have or will impact processing and payment…

All the Medicare Beneficiary Identifier News You Need!

New Look-up Tool for Medicare Beneficiary Identifier is Ready As loyal NAHC Report readers know well by now, the Centers for Medicare & Medicaid Services (CMS) began issuing a new Medicare Card in April, without Social Security Numbers. The cards, which were mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, will be…

MAC Satisfaction Survey Now Available

The 2018 MAC Satisfaction Indicator (MSI), a survey administered by the Centers for Medicare & Medicaid Services (CMS), is now available. The MSI is designed to measure your satisfaction as a Medicare provider with the performance of your Medicare Administrative Contractor (MAC). This survey should only take 10 minutes of your time and helps the…