CMS Issues Instructions for the Misuse of RAPs

The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 10789 that adds a new section to the Medicare Program Integrity Manual addressing actions the Medicare Administrative Contractors (MACs) should implement when potential fraud, waste or abuse is identified in relation to home health agency’s misuse of requests for anticipated payments (RAPs). In…

CMS Updates Program Integrity Manual to Clarify MAC Responsibilities Related to Provider/Supplier Revalidation

On December 29, 2017, the Centers for Medicare & Medicaid Services (CMS) issued Change Request 10386/Transmittal 762, which modifies chapter 8 of the Program Integrity Manual to clarify Medicare Administrative Contractor (MAC) requirements for issuing revalidation approval letters and for releasing revalidation status information to callers over the phone.  The changes reflected in the transmittal…

Preparing for Hospice Targeted Probe and Educate (TPE)

Special thanks to Katie Wehri, CHPC, Healthcare Provider Solutions, Inc., (HPS) for writing today’s story on “Preparing for Hospice Targeted Probe and Educate (TPE)” and to HPS for use of their General Inpatient Level of Care and Medicare Hospice Election Forum audit tools. As previously reported, effective October 1, 2017, the Centers for Medicare &…

Update on the New Medicare Cards

Letters to Providers The Centers for Medicare & Medicaid Services (CMS), through the Medicare Administrative Contractors (MACs), recently mailed letters to all Medicare Fee-For-Service providers about CMS’  work to assign new numbers (known as Medicare Beneficiary Identifiers or MBIs) and issue new Medicare cards to all Medicare beneficiaries beginning in April 2018. CMS’ top priorities…