2018
- CLIA, List of CTP/HCPCS Codes Used to Define Certain Designated Health Service Categories Under Section 1877 of the Social Security Act (Jan .1, 2019)
2018
- OIG, Semiannual Report to Congress: April 1, 2018-September 30, 2018 (Dec. 2018)
- CMS, State Empowerment and Relief Waiver Concepts (Nov. 29, 2018)
- OIG, Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries (Nov. 2018)
- OIG, OIG Advisory Opinion No. 18-14 (Nov. 16, 2018)
- OIG, 2018 Top Management and Performance Challenges (Nov. 2018)
- OIG, OIG Advisory Opinion No. 18-13 (Nov. 6, 2018)
- ONCHIT, Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs (Nov. 2018)
- OIG, Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Patients (Nov. 2018)
- OIG, OIG Advisory Opinion No. 18-12 (Oct. 29, 2018)
- OIG, U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Key Areas That Require Improvement (A-17-18-54000) (Oct. 23, 2018)
- OCR, How HIPAA Allows Doctors to Respond to the Opioid Crisis (Oct. 2018)
- OCR, Resolution Agreement (oct. 2018)
- OIG, OIG Advisory Opinion No. 18-11 (Oct. 18, 2018)
- OIG, Professional Clinical Laboratory, Inc. Did Not Comply with Medicare Requirements for Billing Phlebotomy Travel Allowances (Oct. 2018)
- OCR, Resolution Agreement Advanced Care Hospitalists (Sept. 20, 2018)
- OIG, Advisory Opinion No. 18-10 (Sept. 17, 2018)
- OIG, FDA Should Further Integrate Its Review of Cybersecurity Into the Premarket Review Process for Medical Devices (Sept. 2018)
- OIG, CMS Enrollment System Needs to Enhance Resiliency (Sept. 2018)
- GAO, Rural Hospital Closures (Aug. 2018)
- Committee on Ways and Means, Medicare Red Tape Relief (Aug. 2018)
- OIG, OIG Advisory Opinion No. 18-06 (July 18, 2018)
- OIG, Combating Fraud in Medicare: A Strategy for Success, Testimony of Gloria L. Jarmon (July 17, 2018)
- CMS, 21st Century Cures Act Section 5006 Compliance — Provider Directories (July 17, 2018)
- OIG, Setting Medicare Payment Rates for Clinical Diagnostic Laboratory Tests (July 2018)
- OIG, Medicare Improperly Paid Providers for Items and Services Ordered by Chiropractors (July 2018)
- OIG, The Office of the Secretary of Health and Human Services Did Not Comply with Federal Regulations for Chartered Aircraft and Other Government Travel Related to Former Secretary Price (July 2018)
- OIG, The MEDIC Produced Some Positive Results but More Could be Done to Enhance its Effectiveness (July 2018)
- OIG, Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered By Medicare (July 2018)
- HSGAC, Fueling an Epidemic (July 2018)
- OIG, Weaknesses Exist in Medicaid Managed Care Organizations’ Efforts to Identify and Address Fraud and Abuse (July 2018)
- The Council of Economic Advisers, Expanding Work Requirements in Non-Cash Welfare Programs (July 2018)
- CMS, Proposed Rule for the Quality Payment Program Year 3 (July 2018)
- MEDPAC, A Data Book: Health Care Spending and the Medicare Program (June 2018)
- GAO, Steps Taken to Improve Physician Staffing, Recruitment, and Retention, but Challenges Remain (June 21, 2018)
- CMS, Electronic Visit Verification (May 16, 2018)
- OIG, OIG Advisory Opinion No. 18-02 (May 7, 2018)
- GAO, Small and Rural Practices’ Experiences in Previous Programs and Expected Performance in the Merit-based Incentive Payment System (May 2018)
- CMS, Letter re: New Hampshire Protection Program Premium Assistance (May 7, 2018)
- OIG, The National Institutes of Health, Division of Financial Advisory Services Did Not Always Establish Final Indirect Cost Rates in Accordance with Federal Requirements (May 2018)
- CMS, FAQ, Section 12006 of the 21st Century Cures Act (May 2018)
- CMS, Request for Information on Direct Provider Contracting Models (May 2018)
- HHS, 21st Century Cures Act: Section 13002 –Action Plan for Enhanced Enforcement of Mental Health and Substance Use Disorder Coverage (Apr. 2018)
- DOJ, Controlled Substances Quotes (Apr. 2018)
- CMS, Reinterpretation of “Primarily Health Related” for Supplemental Benefits (Apr. 27, 2018)
- CMS, Reinterpretation of the Uniformity Requirement (Apr. 27, 2018)
- DHCS, Non-Emergency Medical and Non-Medical Transportation Services (Apr. 26, 2018)
- FDA, U.S. Food and Drug Administration and the International Mail Facilities (Apr. 2018)
- OIG, CMS Paid Practitioners for Telehealth Services that Did Not Meet Medicare Requirements (Apr. 2018)
- OIG, CMS’s Policies and Procedures Were Generally Effective in Ensuring that Prescription Drug Coverage Capitation Payments Were Not made After Beneficiaries’ Dates of Death (April 2018)
- U.S. Senate, Opioid Crisis Response Act of 2018
- HHS, S.2680, The Opioid Crisis Response Act of 2018 (Apr. 2018)
- CBO, The Budget and Economic Outlook: 2018-2028 (Apr. 2018)
- GAO, Electronic Health Information: CMS Oversight of Medicare Beneficiary Data Security Needs Improvement (Mar. 2018)
- GAO, Federal Health Insurance Exchange: CMS Needs to Ensure Complete, Accurate Data on Terminations of Coverage for Nonpayment of Premiums (Mar. 2018)
- National Center for Health Statistics, Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2017 (Feb. 2018)
- U.S.D.O.J., Limiting Use of Agency Guidance Documents in Affirmative Civil Enforcement Cases (Jan. 25, 2018)
- CMS, CMS Manual System, Pub. 100-06 Medicare Financial Management, Notice of New Interest Rate for Medicare Overpayments and Underpayments (Jan. 12, 2018)
- OIG, Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00354) (Jan. 11, 2018)
- CMS, Online Provider Directory Review Report (Jan. 2018)
- OIG, Medicare Advantage Encounter Data Show Promise for Program Oversight, But Improvements Are Needed (Jan. 2018)
- CMS, Opportunities to Promote Work and Community Engagement Among Medicaid Beneficiaries (Jan. 11, 2018)
- California, Governor’s Budget Summary 2018-19 (Jan. 10, 2018)
- OCR, Cyber Extortion (Jan. 2018)
- CMS, MLN Matters: Implementation of the Transitional Drug Add-On Payment Adjustment (Jan. 10, 2018)
- CMS, Pub. 100-04 Medicare Claims Processing, New Waived Tests (Jan. 5, 2018)
- OIG, OIG Advisory Opinion No. 17-09 (Jan. 5, 2018)
- HCCIC, Report on Recently Publicized Widespread Processor Vulnerabilities (Jan. 5, 2018)
2017
- CMS, Texting of Patient Information among Healthcare Providers (Dec. 28, 2017)
- CMS, Mississippi 1115 demonstration waiver extension (Dec. 28, 2017)
- OIG, The Food and Drug Administration’s Food-Recall Process Did Not Always Ensure The Safety of the Nation’s Food Supply (Dec. 2017)
- CMS, Advance Notice of Methodological Changes for Calendar Year (CY) 2019 for the Medicare Advantage (MA) CMS-HCC Risk Adjustment Model (Dec. 27, 2017)
- CMS, Letter to Texas Health and Human Services Commissioner re: 1115(a) Waiver (Dec. 21, 2017)
- OCR, HIPAA Privacy Rule and Sharing Information Related to Mental Health (Dec. 2017)
- CMS, 2018 Categorical Adjustment Index Measure Selection (Dec. 2017)
- CMS, The Maryland All-Payer Model Progression Plan (Dec. 16, 2016)
- CMS, Phase-out of expenditure authority for Designated State Health Programs (DSHP ) in Section 1115 Demonstrations (Dec. 15, 2017)
- OIG, OIG Advisory Opinion No. 17-08 (Dec. 15, 2017)
- OIG, Medicaid Fraud Control Units: Investigation and Prosecution of Fraud and Beneficiary Abuse in Medicaid Personal Care Services (Dec. 2017)
- OIG, Potential Misclassifications Reported by Drug Manufacturers May Have Led to $1 Billion in Lost Medicaid Rebates (Dec. 2017)
- OCR, How HIPAA Allows Doctors to Respond to the Opioid Crisis (Dec. 2017)
- GAO, Further Action Needed to Expedite Use of National Data for Program Oversight (Medicaid) (Dec. 2017)
- OCR, HIPAA Helps Caregiving Connections (Dec. 2017)
- GAO, CMS Needs to Fully Align its Antifraud Efforts with the Fraud Risk Framework (Dec. 2017)
- MedPac, Report To Congress: Physician Supervision Requirements in Critical Access Hospitals and Small Rural Hospitals (Dec. 2017)
- FDA, The Least Burdensome Provisions: Concepts and Principles (Dec. 15, 2017)
- CMS, Phase-out of expenditure authority for Designated State Health Programs (DSHP) in Section 1115 Demonstrations (Dec. 15, 2017)
- GAO, CMS Needs to Fully Align its Antifraud Efforts with the Risk Framework (Dec. 2017)
- Opening Statement of the Hon. Gregg Harper, Chairman, Oversight and Investigations Subcommittee, “Examining Concerns of Patient Brokering and Addiction Treatment Fraud” (Dec. 12, 2017)
- House of Representatives, Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, Examining Concerns of Patient Brokering and Addiction Treatment Fraud (Dec. 12, 2017)
- Opening Statement of the Hon. Greg Walden, Chairman, House Energy and Commerce Committee, “Examining Concerns of Patient Brokering and Addiction Treatment Fraud” (Dec. 12, 2017
- OIG, OIG Advisory Opinion No. 17-07 (December 11 , 2017)
- OIG, Summary Report for Fiscal Year 2016 OIG Penetration Testing of Four HHS Operating Division Networks (Dec. 2017)
- FDA, Software as a Medical Device (SAMD): Clinical Evaluation (Dec. 8, 2017)
- U.S. House of Rep. Committee on Energy and Commerce, Hearing Entitled “Examining Concerns of Patient Brokering and Addiction Treatment Fraud” (Dec. 8, 2017)
- FDA, Clinical and Patience Support Sofware (Dec. 8, 2017)
- CMS, MLN Matters:Medicare Does Not Pay Acute-Care Hospitals for Outpatient Services They Provide to Beneficiaries in a Covered Part A Inpatient Stay at Other Facilities (Dec. 6, 2017)
- OIG, Modification of Advisory Opinion 06-04 (Nov. 28, 2017)
- OIG, Semiannual Report to Congress (Dec. 2017)
- OIG, OIG Advisory Opinion No. 17-06 (Nov. 16, 2017)
- H.R.1, Tax Cuts and Jobs Act (Nov. 2017)
- CMS, Risk Corridors Payment and Charge Amounts for the 2016 Benefits Year (Nov. 15, 2017)
- EHR Regulatory Relief Act (Nov. 2017)
- Senate Committee on Finance, Description of the Chairman’s Modification to the Chairman’s Mark of the “Tax Cuts and Jobs Act” (Nov. 15, 2017)
- OIG, Top Management and Performance Challenges Facing HHS (Nov. 2017)
- CBO, Repealing the Individual Health Insurance Mandate: An Updated Estimate (Nov. 2017)
- Joint Committee on Taxation, Estimated Revenue Effects on the Chairman’s Modification to the Chairman’s Mark of the “Tax Cuts and Jobs Act (Nov. 14, 2017)
- CMS, 2018 Updates to the Child and Adult Core Health Care Quality Measurement Sets (Nov. 14, 2017)
- AHRQ, Emergency department (ED): median time from ED arrival to ED departure for admitted ED patients (Nov. 9, 2017)
- AHRQ, Emergency department (ED): admit decision time to ED departure time for admitted patients (Nov. 9, 2017)
- CMS, Remarks by Administrator Seema Verma at the National Association of Medicaid Directors (NAMD) 2017 Fall Conference (Nov. 7, 2017)
- CMS, Section 1115 Demonstration Process Improvements (Nov. 6, 2017)
- The President’s Commission on Combating Drug Addiction and the Opioid Crisis (Nov. 2017)
- CMS, Approval of Opioid Use Disorder/Substance Use Disorder Demonstration Project (Oct. 31, 2017)
- CMS, Approval of Utah’s Section 11115 Demonstration Project (Oct. 31, 2017)
- OIG, Review of The Department of Health and Human Services (HHS) Cancellation of Marketplace Enrollment Outreach Efforts, OEI-12-17-00290 (Oct. 2017)
- IRS, 2018 Limitations Adjusted as Provided in Section 415(d) (Oct. 2017)
- OCR, How HIPAA Allows Doctors to Respond to the Opioid Crisis (Oct. 2017)
- OIG, Testimony Before the Senate Committee on Health, Education, Labor and Pensions (“Implementation of the 21st Century Cures Act”) (Oct. 31, 2017)
- ASPE, Health Plan Choice and Premiums in the Federal Health Insurance Exchange (Oct. 30, 2017)
- OIG, CMS Policies and Procedures Were Generally Effective in Ensuring that Capitation PaymentsWere Not Made After Beneficiaries’ Dates of Death (Oct. 2017)
- FDA, Breakthrough Device Program, Draft Guidance for Industry and FDA Staff (Draft) (Oct. 25, 2017)
- CMS, Pub. 100-08 Medicare Program Integrity, Clarifying Signature Requirements (Oct. 20, 2017)
- HHS, Letter to CMS re: Payments to Issuers for Cost-Sharing Reductions (Oct. 12, 2017)
- OIG, CMS Ensured that Medicare Shared Savings Program Beneficiaries Were Properly Assigned (Oct. 2017)
- FTC, Letter re: Certificate of Need Application (Oct. 16, 2017)
- MEDPAC, Next steps for the Merit-based Incentive Payment System (MIPS) (Oct. 5, 2017)
- CMS, Medicare Provider Reimbursement Manual, Part 2, Provider Cost Reporting Forms and Instructions (Sept. 29, 2017)
- HHS Strategic Plan, FY 2018 – 2022, (Sept. 2017)
- OIG, the Food and Drug Administration Generally Spent Prescription Drug User Fee Collections Appropriately (Sept. 2017)
- OIG, Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2015 Average Prices (Sept. 2017)
- OIG, Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICS and PSCs (Sept. 2017)
- OIG, Shortcomings of Device claims Data Complicate and Potentially Increase Medicare Costs for Recalled and Prematurely Failed Devices (Sept. 2017)
- CA AG, Opinion of Xavier Becerra (Sept. 28, 2017)
- CMS, Enforcement Safe Harbor for Renewal Notices in Connection with the Open Enrollment Period for Non-Grandfathered Coverage in the 2018 Individual Market Benefit Year (Sept. 26, 2017)
- OIG, A Few States Fell Short in Timely Investigation of the Most Serious Nursing Home Complaints: 2011-2015 (Sept. 2017)
- OIG, The Centers for Medicare & Medicaid Services Could Improve Performance Measures Associates with the Fraud Prevention System (Sept. 2017)
- HHS, Medical Identity Theft & Medicare Fraud (Sept. 2017)
- CMS, Disclosure of Creditable Coverage to Medicare Part D Eligible Individuals Guidance (Sept. 18, 2009)
- OIG, Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs (Sept. 2017)
- OIG, Medicare Payments for Clinical Laboratory Tests in 2016: Year 3 of Baseline Data (Sept. 2017)
- OIG, Challenges Remain in FDA’s Inspection of Domestic Food Facilities (Sept. 2017)
- CMS, Summary of Data Reporting for the Medicare Clinical Laboratory Fee Schedule (CLFS) Private Payor Rate-Based Payment System (Sept. 2017)
- CMS, Calendar Year (CY) 2018 Clinical Laboratory Fee Schedule (CLFS) Preliminary Determinations (Sept. 2017)
- CMS, MLN Matters, Medicare Overpayment Manual, Limitation on Recoupment (Sept. 12, 2017)
- OIG, OHRP Should Inform Potential Complainants How They Can Seek Whistleblower Protections (Sept. 2017)
- OIG, Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities (Sept. 2017)
- OIG, Challenges Appear to Limit States’ Use of Medicaid Payment Suspensions (Sept. 2017)
- OIG, Vulnerabilities Remain in Medicare Hospital Outlier Payments (Sept. 2017)
- AHRQ, Transitioning Newborns from NICU to Home (Sept. 2017)
- DHCS, Medi-Cal Provider Training 2017 (Sept. 2017)
- CMS, Centers for Medicare & Medicaid Services: Innovation Center New Direction (Sept. 2017)
- OIG, California Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Properly Recorded, Investigated, and Resolved (Sept. 2017)
- Letter to Stop Medicaid DSH Cuts (Sept. 12, 2017)
- Committee on Energy and Commerce, Subcommittee Makeup (Sept. 11, 2017)
- OIG, Advisory Opinion No. 17-05 (Sept. 7, 2017)
- GAO, HHS Has Made Little Progress Toward Implementing Enhanced Situational Awareness Network Capabilities (Sept. 2017)
- AHRQ, Variation in Health System Characteristics Across States, 2016 (Sept., 2017)
- AHRQ, U.S. Health System Characteristics, 2016 and Compendium (Sept. 2017)
- AHRQ, Snapshot of U.S. Health Systems, 2016 (Sept. 2017)
- CMS, Revisions to State Operations Manual (SOM) Hospital (Sept. 6, 2017)
- CMS, Updated Federal Standard Renewal and Product Discontinuation Notices (Sept. 2, 2017)
- OIG, Drug Supply Chain Security: Wholesalers Exchange Most Tracing Information (Sept. 2017)
- OIG, OIG Advisory Opinion No. 17-04 (Aug. 31, 2017)
- OIG, FDA Oversight of Tobacco Manufacturing Establishments (Aug. 2017)
- OIG, OIG Advisory Opinion No. 17-03 (Aug. 25, 2017)
- CMS, MLN Matters: Prohibition on Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program (Aug. 23, 2017)
- HHS, Hurricane Harvey & HIPAA Bulletin (Aug. 2017)
- OIG, Early Alert: The Centers for Medicare & Medicaid Services Has Inadequate Procedures To Ensure That Incidents of Potential Abuse or Neglect at Skilled Nursing Facilities Are Identified and Reported in Accordance With Applicable Requirements (A-01-17-00504) (Aug. 24, 2017)
- NCHS, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January – March 2017 (Aug. 2017)
- CBO, The Effects of Terminating Payments for Cost-Sharing Reductions (Aug. 2017)
- Congressional Letter to GAO re: Enforcement of Individual Mandate (Aug. 11, 2017)
- CMS, Medicare Part C & D Star Ratings; Update for 2018 (Aug. 9, 2017)
- Commission Report (Aug. 2017)
- OIG, CMS Oversight Must Continue Because All Remaining Consumer Operated and Oriented Plans Were Not Profitable and May Not Be Viable and Sustainable (Aug. 2017)
- OIG, Medicare Shared Savings Program Accountable Care Organizations Have Shown Potential for Reducing Spending and Improving Quality (Aug. 2017)
- CMS, MLN Matters: Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Fiscal Year (FY) 2018 (Aug. 4, 2017)
- OIG, FDA Oversight of Tobacco Manufacturing Establishments (Aug. 2017)
- CMS, MLN Matters, Suppression of the Standard Paper Remittance Advice (SPR) in 45 days if also Receiving Electronic Remittance Advice (ERA) (Aug. 4, 2017)
- IRS, Letter re: Revocation of Tax Exempt Status (Aug. 4, 2017)
- CMS, Targeted Probe & Educate Chart and Data Analysis Definition (August 2017)
- CMS, Affordable Care Act Federal Upper Limit Methodology and Data Elements Guide (Aug. 2017)
- CMS Manual System, Pub. 100-04, Medicare Claims Processing (August 2017)
- CMS, MLN Matters: ICD-10 Coding Revisions to National Coverage Determinations (July 27, 2017)
- CMS, MLN Matters: Updated Editing of Always Therapy Services — MCS (July 27, 2017)
- GAO, Improvements Needed in CMS and IRS Controls over Health Insurance Premium Tax Credit (July 2017)
- NIST, Recommendation for Triple Data Encryption Algorithm (TDEA) Block Cipher (July 2017)
- OIG, HHS’s Office of Refugee Resettlement Improved Coordination and Outreach to Promote the Safety and WEll-Being of Unaccompanied Alien Children (July 2017)
- OIG, OHRP Generally Conducted Its Compliance Activities Independently, But Changes Would Strengthen Its Independence (July 2017)
- House Resolution Committee on the Budget, Balancing the Budget Summary, House Committee on Voting and Chart Deck for 2018 Budget and House Budget Draft (July 2017)
- Executive Order 17-19 (July 19, 2017)
- House Budget Committee, Building a Better America (July 2017)
- HHS, Alaska: State Innovation Waiver Under Section 1332 of the PPACA (July 11, 2017)
- The Boards of Trustees, Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, 2017 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (July 2017)
- OIG, OIG Advisory Opinion No. 17-02 (July 7, 2017)
- OIG, Opioids in Medicare Part D: Concerns about Extreme Use and Questionable Prescribing (July 2017)
- OIG, 2017 National Health Care Fraud Takedown and Image Gallery (July 2017)
- CMS, MLN Matters, The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year 2015 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCH) (June 2017)
- GAO, Medicaid Expansion: Behavioral Health Treatment Use in Selected States in 2014 (June 2014)
- OIG, Part D Plans Generally Include Commonly Used by Dual Eligibles: 2017 (June 2017)
- CMS, MLN Matters: Qualified Medicare Beneficiary Indicator in the Medicare Fee-For-Service Claims Processing System (June 2017)
- GAO, Hospital Value-Based Purchasing: CMS Should Take Steps to Ensure Lower Quality Hospitals Do Not Qualify for Bonuses (June 2017)
- CBO, HR 1628, Better Care Reconciliation Act of 2017 (June 26, 2017)
- HCUP, Patient Characteristics of OpioidRelated Inpatient Stays and Emergency Department Visits Nationally and by State, 2014 (June 2017)
- Committee on Energy and Commerce, Letter to CMS re: unimplemented recommendations (June 23, 2017)
- OIG, Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply with Federal Requirements (June 2017)
- OIG, Status Update: T-MSIS Data Not Yet Available for Overseeing Medicaid (June 2017)
- MEDPAC, Report to the Congress: Medicare and the Health Care Delivery System (June 2017)
- CMS, MLN Matters, Provider Enrollment Revalidation — Cycle 2 (June 15, 2017)
- CMS, Medicare Secondary Payer (June 2017)
- MACPAC, Report to Congress on Medicaid and CHIP (June 2017)
- MEDPAC, Health Care Spending and the Medicare Program (June 2017)
- OCR, My entity just experienced a cyber-attack! What do we do now? (June 2017)
- CMS, Medicare Learning Network, Fraud and Abuse Products (June 2017)
- OCR, Cyber-Attack Quick Response (June 2017)
- CMS, Estimated Financial Effect of the “American Health Care Act of 2017) (June 13, 2017)
- CMS, 2017 Effectuated Enrollment Snapshot (June 12, 2017)
- AHRQ, Patient Characteristics of Opioid-Related Inpatient Stays and Emergency Department Visits Nationally and by State, 2014 (June 2017)
- CMS, MLN Matters, July 2017 Update of the Ambulatory Surgical Center Payment System (June 9, 2017)
- OIG, 2016 Performance Data for the Senior Medicare Patrol Projects (June 8, 2017)
- CMS, 2015 Reporting Experience Including Trends (2007-2015) (June 2017)
- CMS, MLN Matters, New Common Working File (CWF) Medicare Secondary Payer (MSP) Type for Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault Medicare Set-Aside Arrangements (NFMSAs) (June 8, 2017)
- OCR, Cybersecurity Incidents will happen…Remember to Plan, Respond and Report! (May 2017)
- IRS, SOI Bulletin (May 2015)
- OIG, Semiannual Report to Congress (October 1, 2016 to March 31, 2017) (May 2017)
- CMS, MLN Mattes, July 2017 Update of the Hospital Outpatient Prospective Payment System (May 30, 2017)
- CMS, MLN Matters, Scheduled End of the Intravenous Immune Globulin Demonstration (May 30, 2017)
- CMS, MLN Matters, Remittance Advice Remark Code, Claims Adjustment Reason Code, Medicare Remit Easy Print, and PC Print Update (May 26, 2017)
- CMS, MLN Mattes, Claim Status Category and Claim Status Codes Update (May 26, 2017)
- CMS, MLN Matters, Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): CORE 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) (May 26, 2017)
- CMS, MLN Matters, Required Workaround for Hospices Submitting Routine Home Care and Service Intensity Add-On (May 24, 2017)
- CBO, H.R. 1628, American Health Care Act of 2017 Cost Estimate (May 24, 2017)
- CMS, MLN Matters, Medicare Care Choices Model (May 18, 2017)
- CMS, Basic Health Program; Funding Methodology for Program Year 2018 (May 17, 2017)
- OIG, CDC Generally Met Its Inspection Goals for the Federal Select Agent Program (May 2017)
- OCR, Resolution Agreement with St. Luke’s Spencer Cox Center for Health (May 8, 2017)
- CMS, Affordable Care Act Federal Upper Limit Methodology Data Elements Guide (May 2017)
- OIG, Compendium of Unimplemented Recommendations (May 2017)
- HR 2581, Verify First Act
- HR 2579, Cobra Continuation Coverage
- HR 2372, Verteran Act
- OIG, Justification for Estimates for Appropriations Committees (Fiscal Year 2018) (May 2017)
- OIG, Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for all Power Mobility (May 2017)
- OIG, Medicare Could Save Millions By Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices (May 2017)
- OIG, Medicaid Fraud Control Units Fiscal Year 2017 Annual Report (May 2017)
- OIG, HHS Did Not Identify and Report Antideficiency Act Violations (May 2017)
- NCHIT, HHS Update #4: International Cyber Threat to Healthcare Organizations (Revised) (May 2017)
- CMS, Proxy Direct Enrollment Pathway for 2018 Individual Market Open Enrollment Period (May 17, 2017)
- CMS, MLN Matters: Updated Manual Guidelines for Electronic Funds Transfer Payments and Change of Ownership (May 16, 2017)
- CHIT, HHS Update #3: International Cyber Threat to Healthcare Organizations (Resend) (May 15, 2017)
- CMS, The Future of the SHOP: CMS Intends to Allow Small Businesses in SHOPs Using HealthCare.gov More Flexibility when Enrolling in Healthcare Coverage (May 15, 2017)
- CMS, MLN Matters: Quarterly Update to the Medicare Physician Fee Schedule Database (May 12, 2017)
- CMS, MLN Matters: Prohibition on Billing Dually Eligible Individuals Enrolled in the Qualified Medical Beneficiary (QMB) Program (May 12, 2017)
- CMS, MLN Matters: Changing to the Payment Policies for Reciprocal Billing Arrangements and Fee-For-Time Compensation Arrangements (formerly referred to as Locum Tenens Arrangements) (May 12, 2017)
- CMS, MLN Matters: MCS Implementation of the Restructured Clinical Lab Fee Schedule (May 12, 2017)
- CMS, MLN Matters: New Waived Tests (May 12, 2017)
- CMS, MLN Matters: New Common Working Filing Medicare Secondary Payer Type for Liability Medicare Set-Aside Arrangements and No-Fault Medicare Set-Aside Arrangements (May 10, 2017)
- CMS, Extension Transition Period for Compliance with Home and Community-Based Settings (May 9, 2017)
- American Health Care Act of 2017 (with amendments) and Report of the Committee on the Budget, House of Representatives, to Accompany HR 1628 together with Minority Views (May 4, 2017)
- House Appropriations Committee, FY 2017 Omnibus Summary – Labor, Health and Human Services, and Education Appropriations (May 2017)
- CMS, Medicaid Drug Rebate Program Notice (May 2, 2017)
- California Dept. of Health Services, Alcohol and/or Other Drug Program Certification Standards (May 1, 2017)
- HHS, ASPR, National Health Security Strategy and Implementation Plan (May 2017)
- CMS, Checklist for Section 1332 State Innovation Waiver Applications, including specific items applicable to High-Risk Pool/State-Operated Reinsurance Program Applications (May 2017)
- AHCA, Frequently Asked Questions (May 2017)
- FBI, How to Protect Your Networks from Ransomware (May 2017)
- CMS, Comprehensive Primary Care Plus (Regions and Payer Partners) (May 2017)
- DOJ, Evaluation of Corporate Compliance Programs (May 2017)
- CMS, MLN Matters: The Process of Prior Authorization (May 1, 2017)CMS, MLN Matters: Improvements to the Adjudication Process of Serial Claims (Apr. 26, 2017)
- FCC, Public Notice Requests Comments on Broadband-Enabled Health Care Solutions and Advanced Technologies (Apr. 24, 2017)
- IRS, Tax Treatment of Benefits Paid by Self-Funded Plans (Apr. 24, 2017)
- CMS, MLN Matters, Next Generation Accountable Care Organization — All Inclusive Population Based Payment Implementation (Apr. 20, 2017)
- OIG, CMS Validated Hospital Inpatient Quality Reporting Program Data, But Should Use Additional Tools to Identify Gaming (Apr. 2017)
- GAO, Medicare Advantage: CMS Should Use Data on Disenrollment and Beneficiary Health Status to Strengthen Oversight (April 2017)
- HHS, Trump Administration awards grants to states to combat opioid crisis (Apr. 19, 2017)
- OCR, Resolution Agreement with Center for Children’s digestive Health (Apr. 2017)
- OCR, Resolution Agreement with Cardio Net, Inc. (Apr. 2017)
- GAO, Medicaid Program Integrity: CMS Should Build on Current Oversight Efforts by Further Enhancing Collaboration with States (Apr. 2017)
- AHRQ, Introduction to the HCUP Nationwide Readmissions Database 2014 (Apr. 2017)
- AHRQ, Introduction to the HCUP State Emergency Department Databases (Apr. 2017)
- AHRQ, Introduction to the HCUP State Inpatient Databases (SID) (Apr. 2017)
- AHRQ, Introduction to the HCUP State Ambulatory Surgery and Services Databases (Apr. 2017)
- OIG, California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers (Apr. 2017)
- GAO, Telehealth and Remote Patient Monitoring Use in Medicare and Selected Federal Programs (Apr. 2017)
- IRS, What You can Expect When the IRS Assigns Your Account to a Private Collection Agency (Apr. 2017)
- CMS, Manual System, Pub. 100-08 Medicare Program Integrity (Apr. 14, 2017)
- HHS, Overlooking risks leads to breach, $400,000 settlement (Apr. 12, 2017)
- FDA, Warning Letter to Abbott Cardiovascular and Neuromodulation (Apr. 12, 2017)
- Noridian Healthcare Solutions, LLC, Recovery Auditor (RAC) Program: Part A Provider Outreach and Education (POE) (Apr. 2017)
- CMS, MLN Matters, Provider Enrollment Revalidation — Cycle 2 (Apr. 10, 2017)
- CMS, MLN Matters, Educational Resources to Assist Chiropractors with Medicare Billing (Apr. 7, 2017)
- OCR, Resolution Agreement with Metro Community Provider Network (Apr. 7, 2017)
- Treasury Inspector General for Tax Administration, Affordable Care Act: Assessment of Efforts to Implement the Employer Shared Responsibility ProvisionsAffordable Care Act: Assessment of Efforts to Implement the Employer Shared Responsibility Provisions (Apr. 7, 2017)
- CMS, Racial and Ethnic Disparities by Gender in Health Care in Medicare Advantage (Apr. 2017)
- CMS, Gender Disparities in Health Care in Medicare Advantage (Apr. 2017)
- CMS, Home Health Pre-Claim Review Demonstration Pause Questions and Answers (Apr. 2017)
- OCR, Man-in-the-Middle Attacks and “HTTPS Inspection Products” (Apr. 2017)
- CMS, Voluntary Self-Referral Disclosure Protocol (Apr. 2017)
- CMS, Instructions for Disclosures of Noncompliance with the Physician Self-Referral Law Arising Solely from a Violation of 42 C.F.R. § 411.362(b)(3)(ii)(C) (Apr. 2017)
- GAO, VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions (Mar. 2017)
- S.761, Health Care Options Act of 2017 (Mar. 29, 2017)
- OIG, Measuring Compliance Program Effectiveness: A Resource Guide (Mar. 27, 2017)
- Summary, The Health Care Options Act of 2017 (Mar. 2017)
- HR 1101, Small Business Health Fairness Act of 2017 (Mar. 2017)
- OIG, Hospitals Nationwide Generally Did Not Comply with Medicare Requirements for Billing Outpatient Right Heart Catheterizations with Heart Biopsies (Mar. 2017)
- OIG, Data Inadequacies Undermine CMS’s Oversight of the Inconsistency Resolution Process for the Federal Marketplace (Mar. 2017)
- Amendment in the Nature of a Substitute to H.R. 1313, Preserving Employee Wellness Programs Act (Mar. 2017)
- Amendment in the Nature of a Substitute to H.R. 1101, Small Business Health Fairness Act of 2017 (Mar. 2017)
- Amendment in the Nature of a Substitute to H.R. 1304, Self Insurance Protection Act (Mar. 2017)
- MACPAC, Report to Congress on Medicaid and CHIP (Mar. 2017)
- MEDPAC, Report to the Congress: Medicare Payment Policy (Mar. 2017)
- CMS, MLN Matters, Provider Enrollment Revalidation — Cycle 2 (Mar. 15, 2017)
- CMS, Health Insurance Marketplaces 2017 Open Enrollment Period Final Enrollment Report: November 1, 2017 – January 30, 2017 (Mar. 15, 2017)
- The White House, Presidential Executive Order on a Comprehensive Plan for Reorganizing the Executive Branch (Mar. 13, 2017)
- CBO, American Health Care Act (Mar. 13, 2107)
- HHS, Letter from Thomas Price, M.D. to Governors (Mar. 13, 2017)
- OIG, Hospitals Nationwide Generally Did Not Comply with Medicare Requirements For Billing Outpatient Right Heart Catheterizations with Hearth Biopsies (Mar. 2017)
- CMS, MLN Matters, Federally Qualified Health Centers Prospective Payment System Recurring File Updates (Mar. 10, 2017)
- OIG, Notice of Modification of OIG Advisory Opinion No. 02-1 (Mar. 10, 2017)
- OIG, OIG Advisory Opinion No. 17-01 (Mar. 10, 2017)
- CMS, Medicaid Drug Rebate Program Notice (Mar. 9, 2017)
- CMS, Medicare Outpatient Observation Notice Frequently Asked Questions and forms (Mar. 8, 2017)
- CMS, MLN Matters, Clarification for Patient Discharge Status Codes and Hospital Transfer Policies (Mar. 8, 2017)
- Letter from Thomas E. Price, M.D. Re: Budget Reconciliation legislative Recommendations (Mar. 7, 2017)
- OCR, HCCA 2017 Compliance Institute (Mar. 7, 2017)
- OIG, MFCU Statistical Data for Fiscal Year 2016 (Mar. 2017)
- Budget Reconciliation Legislative Recommendations Relating to Repeal and Replace of the Patient Protection and Affordable Care Act (Mar. 6, 2017)
- OIG, Review of Blue Cross Blue Shield Association Final Administrative Cost Proposals for Fiscal Years 2010 through 2015 (Mar. 2017)
- CBO, Answers to Questions for the Record Following a Hearing on the Budget and Economic Outlook for 2017 to 2027 Conducted by the House Committee on the Budget (Mar. 3, 2017)
- OIG, Medicare Contractors’ Payments to Providers for Hospital Outpatient Dental Services Generally Did Not Comply with Medicare Requirements (Mar. 2017)
- Treasury Inspector General for Tax Administration, Affordable Care Act: Verification of Premium Tax Credit Claims During the 2016 Filing Season (Mar. 2, 2017)
- OIG, Medicaid Fraud Control Units Statistical Data for Fiscal Year 2016 and Interactive Map (Mar. 2017)
- CMS, MLN Matters: Updates to the “Medicare Claims Processing Manual,” Pub. 100-04, Chapters 12, 17 and 23 to Correct Remittance Advice Messages (Feb. 24, 2017)
- CMS, MLN Matters: Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update (Feb. 24, 2017)
- CMS, MLN Matters: Healthcare Provider Taxonomy Codes (Feb. 24, 2017)
- CMS, MLN Booklet: Reading A Professional Remittance Advice (Feb. 2017)
- OIG, Review of the Department of Health and Human Services’ Compliance with the Federal Information Security Modernization Act of 2014 For Fiscal Year 2016 (Feb. 2017)
- CMS, Extended Transition to Affordable Care Act-Compliant Policies (Feb. 23, 2017)
- Rep. Sander Levin, Letter to Committee on Ways and Means (Feb. 22, 2017)
- CMS, MLN Matters: Episode Payment Model Operations (Feb. 17, 2017)
- CMS, MLN Matters: ICD-10 Coding Revisions (Feb. 17, 2017)
- H.R. 1156 (Feb. 16, 2017)
- CMS, MLN Matters: Guidance on Implementing System Edits for Certain Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (Feb. 10, 2017)
- CMS, MLN Matters: Extension of the Transition to the Fully Adjusted Durable Medical Equipment Prosthetics, Orthotics, and Supplies Payment Rates Under Section 16007 of the 21st Century Cures Act (Feb. 10, 2017)
- HHS, Advance Notice Methodological Changes for Calendar Year (CY) 2018 for Medicare Advantage (MA) Capitation Rates, Part C and Part D Payment Policies and 2018 Call Letter (Feb. 1, 2017)
- OACT, Projections of National Health Expenditures: Methodology and Model Specification, Accuracy Analysis of the Short-Term (11-Year) National Health Expenditure Projections, 1960 – 2025 Data, and Projection Tables (Feb. 2017)
- OCR, Reporting and Monitoring Cyber Threats (Feb. 2017)
- NCHS, Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–September 2016 (Feb. 2017)
- OIG, Medicare Market Shares of Mail-Order Diabetes Test Strips From July Through September 2016 (Feb. 2017)
- CMS, Market Saturation and Utilization Data Tool (Feb. 2, 2017)
- DOJ, Evaluation of Corporate Compliance Programs (Feb. 2017)
- State of New Jersey, Senate No. 3, Requires health insurance coverage for treatment of substance use disorders; places certain restrictions on the prescription of opioid and certain other drugs; concerns continuing education related thereto (Jan. 31, 2017)
- AHRQ, Calculating Nationwide Readmissions Database (NRD) Variances, Report #2017-01 (Jan. 24, 2017)
- GAO, Medicaid Managed Care: Improved Oversight Needed of Payment Rates for Long-Term Services and Support (Jan. 2017)
- GAO, Medicare Advantage: Limited Progress Made to Validate Encounter Data Used to Ensure Proper Payments (Jan. 2017)
- CMS, MLN Matters; New Waived Tests (Jan. 20, 2017)
- GAO, CMS Needs Better Data to Monitor the Provision of and Spending on Personal Care Services (Jan. 2017)
- CMS Manual System, Pub 100-04 Medicare Claims Processing, Medicare Outpatient Observation Notice (MOON) Instructions (Jan. 20, 2017)
- CMS, MLN Matters; The Process of Prior Authorization (Jan. 20, 2017)
- OCR, Notice of Final Determination (Children’s Medical Center) (Jan. 18, 2017)
- CMS, New Participants Join Several CMS Alternative Payment Models (Jan. 18, 2017)
- IRS, Rev. Proc. 2017-13 (Jan. 17, 2017)
- DOL, Letter to Vanessa A. Scott, Esq. re: ERISA (Jan. 13, 2017)
- CBO, The Budget and Economic Outlook: 2017 to 2027 (Jan. 2017)
- Congress, H.R. 372 (Jan. 9, 2017)
- OIG, Review of California Medicaid Managed-Care Program Potential Savings with Minimum Medical Loss Ratio (Jan. 2017)
- OIG, Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2015 (Jan. 2017)
- GAO, HHS Needs to Improve Planning and Evaluation of Its Efforts to Increase Information Exchange Post-Acute Care Settings (Jan. 2017)
- FDA, Regulation of Intentionally Altered Genomic DNA in Animals (Jan. 2017)
- CMS, CMS announces extension of 2016 reporting deadline and intends to modify 2017 requirements for reporting eCQM data under the Inpatient Quality Reporting and EHR Incentive Programs for Hospitals (Jan. 17, 2017)
- CMS, Online Provider Directory Review Report (Jan. 2017)
- CMS, Data Brief: Sharp reduction in avoidable hospitalizations among long-term care facility residents (Jan. 17, 2017)
- OIG, Independent Attestation Review: National Institutes of Health Fiscal Year 2016/Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00352) (Jan. 11, 2017)
- OIG, Independent Attestation Review: Substance Abuse and Mental Health Services/ Administration Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00353) (Jan. 10, 2017)
- OIG, Independent Attestation Review: Health Resources and Services Administration / Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00354) (Jan. 10, 2017)
- FDA, Demonstrating Interchangeability With a Reference Product (Jan. 2017)
- DOJ, The Department of Health and Human Services And The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2016 (Jan. 2017)
- DOL, FAQs About Affordable Care Act Implementation Part 36 (Jan. 9, 2017)
- CBO, How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums (Jan. 2017)
- HHS, Health Insurance Coverage for Americans with Pre-Existing Conditions: The Impact of the Affordable Care Act (Jan. 5, 2017)
- CMS, MLN Matters: Outlier Limitation on Outpatient Prospective Payment System Community Mental Health Centers Services (Jan. 3, 2017)
- OCR, Resolution Agreement (Jan. 3, 2017)
- CMS, MLN Matters: Calendar Year Annual Updates for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (Jan. 3, 2017)
- HHS, Note Regarding Implementation of Sections 16001 and 16002 of the 21st Century Cures Act (Jan. 2017)
- CMS, MLN Matters: January 2017 Update of the Hospital Outpatient Prospective Payment System (Jan. 3, 2017)
- IRS, Rev. Proc. 2016-55. Inflation Adjusted Items for 2017 (eff. Jan. 1, 2017)
- OIG, High Price Drugs Are Increasing Federal Payments for Medicare Part D Catastrophic Coverage (Jan. 2017)
- CMS, 2017 Medicare Electronic Health Record Incentive Program Payment Adjustment Fact Sheet for Eligible Professionals (Jan. 2017)
- CRS, Congressional Careers: Service Tenure and Patterns of Member Service, 1789-2017 (Jan. 3, 2017)
- IRS, Rev. Proc. 2016-28, Inflation Adjusted Amounts for HSAs (eff. Jan. 1, 2017)
- OIG, Work Plan 2017
- EEOC, Sample Notice for Employer-Sponsored Wellness Programs (Jan. 2017)
2016
- CMS, Affordable Care Act Upper Limit Methodology and Data Elements Guide (Dec. 2016)
- HHS, Clinical Pharmacology Data to Support a Demonstration of Biosimilarity to a Reference Product (Dec. 2016)
- FDA, Postmarket Management of Cybersecurity in Medical Devices (Dec. 28, 2016)
- OIG, OIG Advisory Opinion No. 16-13 (Dec. 20, 2016)
- OIG, Case Review of Inpatient Rehabilitation Hospital Patients Not Suited for Intensive Therapy (Dec. 2016)
- OIG, Early Implementation Review: CMS’s Management of the Quality Payment Program (Dec. 2016)
- HHS, NPI: What You Need to Know (Dec. 2016)
- FTC, Iowa Board of Physician Assistants, Proposed New Rules: 645-327.8: Definition of physician supervision of a physician assistant (Dec. 20, 2016)
- U.S. Senate, Special Committee on Aging (Dec. 2016)
- California State Auditor, Significant Delays and Inadequate Oversight of the Complaint Resolution Process Have Allowed Some Nurses Who May Pose a Risk to Patient Safety to Continue Practicing (Dec. 2016)
- OIG, Vulnerabilities Remain Under Medicare’s 2-Midnight Hospital Policy (Dec. 2016)
- CMS, MLN Matters: Summary of Policies in the Calendar Year (CY) 2017 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, and CT Modifier Reduction List (Dec. 16, 2016)
- FinCEN, FBAR Filing Requirements for Certain Financial Professionals (FinCEN Notice 2016-1) (Dec. 16, 2016)
- CMS, MLN Matters: Prolonged Services Without Direct Face-to-Face Patient Contact Separately Payable Under the Physician Fee Schedule (Manual Update) (Dec. 16, 2016)
- CMS, MLN Matters: Shared Savings Program (SSP) Accountable Care Organization (ACO) Qualifying Stay Edits (Dec. 16, 2016)
- CMS, MLN Matters: Sample Hospice Election Statement (Dec. 13, 2016)
- CMS, MLN Matters: Clarification of Certification Statement Signature and Contact Person Requirements (Dec. 9, 2016)
- CMS, MLN Matters: Comprehensive Care for Joint Replacement (CJR) Model: Skilled Nursing Facility (SNF) 3-Day Rule Waiver (Dec. 9, 2016)
- OIG, Office of Inspector General Policy Statement Regarding Gifts of Nominal Value To Medicare and Medicaid Beneficiaries (Dec. 7, 2016)
- HHS, Report to Congress; Prescription Drugs, Innovation, Spending and Patient Access (Dec. 7, 2016)
- U.S. Senate, Concurrent and Overlapping Surgeries: Additional Measures Warranted (Dec. 7, 2016)
- CMS, Form CMS 10611-MOON (English) and Form CMS 10611-MOON (Spanish), with instructions (Dec. 2016)
- OIG, OIG Advisory Opinion No. 16-12 (Dec. 5, 2016)
- CRS, “Major” Obama Administration Rules Potentially Eligible to be Overturned under the Congressional Review Act in the 115th Congress (Nov. 17, 2016)
- CMS, List of Measures under Consideration for December 1, 2016 (Nov. 2016)
- ONCHIT, Safety Assurance Factors for EHR Resilience (Nov. 2016)
- CMS, Risk Corridors Payment and Charge Amounts for the 2015 Benefit Year (Nov. 16, 2016)
- OIG, Semi-Annual Report to Congress (Nov. 2016)
- CMS, Draft 2018 Letter to Issuers in the Federally-facilitated Marketplaces (Nov. 10, 2016)
- CRS, Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act (Nov. 10, 2016)
- IRS, Notice 2016-64, Section 4375 & 4376 — Insured and Self-Insured Health Plans (Nov. 2016)
- Cybersecurity Vulnerabilities Letter (Nov. 3, 2016)
- CMS, 2016 Hospital Appeals Settlement Process (Nov. 2016)
- ONCHIT, 2016 Report To Congress on Health IT Progress (Nov. 2016)
- CMS, CMS Finalizes Hospital Outpatient Prospective Payment Changes for 2017 (Nov. 1, 2016)
- AHRQ, The Hospital Guide to Reducing Medicaid Readmissions and Tools (Oct. 2016)
- OCR, What Type of Authorization Is Right for You? (Oct. 2016)
- HHS, FAQs about Affordable Care Act Implementation Part 34 and Mental Health and Substance Use Disorder Parity Implementation (Oct. 27, 2016)
- OCR, Sharing Consumer Health Information? Look to HIPAA and the FTC Act (Oct. 2016)
- HHS, Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace (Oct. 24, 2016)
- OIG, Colorado Did Not Meet Federal System Security Requirements (Oct. 2016)
- CMS, Seamless Enrollment of Individuals upon Initial Eligibility for Medicare (Oct. 21, 2016)
- OIG, State Agencies Claimed Unallowable and Unsupported Medicaid Reimbursements for Services Under the Home and Community-Based Services Waiver Program (Oct. 2016)
- OCR, Resolution Agreement (Oct. 11, 2016)
- OIG, OIG Advisory Opinion No. 16-10 (Oct. 11, 2016)
- Office of the President of the United States, The Mental Health & Substance Use Disorder Parity Task Force, Final Report (Oct. 2016)
- CMS, Medicaid Drug Rebate Program Notice (Oct. 5, 2016)
- OIG, Investigative Advisory on Medicaid Fraud and Patient Harm Involving Personal Care Services (Oct. 3, 2016)
- GAO, Private Insurance: In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 (Sept. 2016)
- OIG, California Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (Sept. 2016)
- GAO, Department of Health and Human Services: Transitional Reinsurance Program (Sept. 29, 2016)
- OIG, Hospices Should Improve Their Election Statements and Certifications of Terminal Illness (Sept. 2016)
- OIG, OIG Advisory Opinion No. 16-09 (Sept. 23, 2016)
- OIG, Medicaid Fraud Control Units Fiscal Year 2015 Annual Report (Sept. 2016)
- HHS, Head Start Program Performance Standards (Sept. 2016)
- OIG, Medicare Improperly Paid Millions of Dollars for Unlawfully Present Beneficiaries for 2013 and 2014 (Sept. 2016)
- OIG, Escalating Medicare Billing for Ventilators Raises Concerns (Sept. 2016)
- OIG, Medicare Payments for Clinical Diagnostic Laboratory Tests in 2015 (Sept. 2016)
- OIG, Medicare Payments for Clinical Diagnostic Laboratory Tests: an Update on CMS Progress Medicare Payments for Clinical Diagnostic Laboratory Tests: an Update on CMS Progress (Sept. 2016)
- OIG, CMS Should Address Medicare’s Flawed Payment System for DME Infusion Drugs (Sept. 2016)
- CMS, Risk Corridors Payments for 2015 (Sept. 9, 2016)
- GAO, Results of Undercover Enrollment Testing for the Federal Marketplace and a Selected State Marketplace for the 2016 Coverage Year (Sept. 2016)
- GAO, Final Results of Undercover Testing of the Federal Marketplace and Selected State Marketplaces for Coverage Year 2015 (Sept. 2016)
- GAO, Private Insurance: In Most States and New Exchanges, Enrollees Continued to be Concentrated among Few Issuers in 2014 (Sept. 2016)
- FDA, FDA requires strong warnings for opioid analgesics, prescription opioid cough products, and benzodiazepine labeling related to serious risks and death from combined use (Aug. 31, 2016)
- GAO, HHS Needs to Strengthen Security and Privacy Guidance and Oversight (Aug. 2016)
- OIG, Guidance on IRO Independence and Objectivity (Aug. 2016)
- OIG, Conversions of Startup Loans into Surplus Notes by Consumer Operated and Oriented Plans Were Allowable but Not Always Effective (Aug. 2016)
- OIG, State Governments May Unduly Benefit Financially from Publicly Owned but Privately Operated Entities (Aug. 15, 2016)
- CMS, MLN Matters: Timely Reporting of Provider Enrollment Information Changes (Aug. 2016)
- CMS, MLN Matters: New Place of Service (POS) Code for Telehealth and Distant Site Payment Policy (Aug. 12, 2016)
- OIG, Public Summary Report: The Departments of Health and Human Services Security Management Practices for Computer Systems with Access to Personally Identifiable Information (Aug. 2016)
- OIG, MACs Continue to Use Different Methods to Determine Drug Coverage (Aug. 2016)
- HHS, Resource for Entities Covered by Section 1557 of the Affordable Care Act – Estimates of at Least the Top 15 Languages Spoken by Individuals with Limited English Proficiency for the 50 States, the District of Columbia, and the U.S. Territories (Aug. 2016)
- CMS, Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and Audio/Video Recordings by Nursing Home Staff (Aug. 5, 2016)
- GAO, Medicaid: Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding (Aug. 2016)
- GAO, Physician-administered Drugs: Comparison of Payer Payment Methodologies (Aug. 1, 2016)
- OIG, OIG Advisory Opinion No. 16-08 (July 27, 2016)
- CDRH, General Wellness: Policy for Low Risk Devices (July 29, 2016)
- Senate Finance Committee, Why Stark, Why Now? (July 2016)
- HHS, Fact Sheet: Ransomeware and HIPAA (July 2016)
- OIG, Commonsense Principles of Corporate Governance (July 2016)
- CMS, Comprehensive Primary Care Plus Handout (July 2016)
- GAO, CMS Should Take Additional Steps to Verify Accuracy of Data Used to Set Payment Rates for Drugs (July 2016)
- OIG, Governance Principles: Hospitals Largely Reported Addressing Requirements for EHR Contingency Plans (July 2016)
- OCR, Section 1557 of the Affordable Care Act – Presenter’s Guide and Training Slides (July 2016)
- OIG, Notice of Modification of OIG Advisory Opinion No. 10-12 (July 22, 2016)
- CMS, Evaluation of National Distributions of Overall Hospital Quality Star Ratings (July 21, 2016)
- OIG, Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries (July 2016)
- CMS, Medicaid Drug Rebate Program Notice For State Technical Contacts (July 14, 2016)
- OIG, FDA Is Issuing More Postmarketing Requirements, But Challenges With Oversight Persist (July 2016)
- CMS, Medicare Outpatient Observation Notice (MOON) (July 2016)
- CMS, Annual Income Threshold Adjustment FAQ (July 2016)
- HHS, Examining Oversight of the Privacy & Security of Health Data Collected by Entities Not Regulated by HIPAA (June 2016)
- CMS, Federal Public Notice and Public Process Requirements for Changes to Medicaid Payment Rates (June 24, 2016)
- CMS, Guidance on Annual Eligibility Redetermination and Re-Enrollment for Marketplace Coverage for 2017 (June 2016)
- CMS, Medicare Enrollment for Institutional Providers (June 2016)
- OIG, Memorandum Report: Part D Plans Generally Include Drugs Commonly Used By Dual Eligibles (June 29, 2016)
- OIG, State Efforts to Exclude 340B Drugs from Medicaid Managed Care Rebates (June 2016)
- Cal. DOI, Proposed Merger of Anthem, Inc. and Cigna Corporation (June 16, 2016)
- CMS, Medicare Enrollment for Physicians and Other Part B Suppliers (June 2016)
- CMS, Medicare Fee-for-Service Recovery Audit Program (June 2016)
- MACPAC, Report to Congress on Medicaid and CHIP (June 2016)
- OIG, High Part D Spending on Opioids and Substantial Growth in Compounded Drugs Raise Concerns (June 2016)
- MEDPAC, Health Care Spending and the Medicare Program (June 2016)
- HR 2646, Helping Families in Mental Health Crisis Act of 2016 (June 2016)
- ONCHIT, Connecting Health and Care for the Nation (June 2016)
- ONCHIT, Progress on Health IT Patient Safety Action and Surveillance Plan (June 2016)
- ONCHIT, Certification Program (June 2016)
- ONCHIT, A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure (June 2016)
- ONCHIT, Interoperability Among U.S. Non-Federal Acute Care Hospitals in 2016 (June 2016)
- HHS, Individuals’ Right Under HIPAA to Access their Health Information (June 2016)
- HHS, Measuring Progress on Mental Health and Substance Use Disorder Parity (June 7, 2016)
- MEDPAC, Medicare and the Health Care Delivery System (June 2016)
- GAO, Federal Action Needed to Better Align Payments with Costs (Hospital Uncompensated Care) (July 2016)
- OIG, Fiscal Year Work Plan – Mid-Year Update 2016 (June 2016)
- ONC, Federal Health IT Strategic Plan, 2015-2020 (June 2020)
- HI/SMI, 2016 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Fund (June 22, 2016)
- HHS, Impacts of the Affordable Care Act’s Medicaid Expansion on Insurance Coverage and Access to Care (June 20, 2016)
- OIG, Nationwide Analysis of Common Characteristics in OIG Home Health Fraud Cases (June 2016)
- OIG, Early Alert: The Food and Drug Administration Does Not Have an Efficient Food Recall Initiation Process (June 8, 2016)
- OIG, Medicare Improperly Paid Hospitals for Beneficiaries Who Had Not Received 96 or More Consecutive Hours of Mechanical Ventilation (June 2016)
- OIG, Memorandum Report: Performance Data for the Senior Medicare Patrol Projects (June 3, 2016)
- MEDPAC, Comment on CMS Hospice Wage Index and Payment Rate (May 26, 2016)
- HHS, Report of the Evidence on Health IT Safety and Interventions (Final Report) (May 2016)
- HHS, Goals and Priorities for Health Care Organizations to Improve Safety Using Health IT (Revised Report) (May 2016)
- The White House, Precision Medicine Initiative: Data Security Policy Principles and Framework (May 25, 2016)
- OIG, CMS is Taking Steps to Improve Oversight of Provider-Based Facilities, But Vulnerabilities Remain (May 2016)
- CLIA, Direct Access Testing and the Clinical Laboratory Improvement Amendments Regulations (May 2016)
- CLIA, What Is CMS’ Authority Regarding laboratory Developed Tests? (May 2016)
- CLIA, Research Testing and CLIA (May 2016)
- GAO, Food and Drug Administration: Comprehensive Strategic Planning Needed to Enhance Coordination between Medical Product Centers (May 2016)
- OIG, Medicare Benefit Integrity Contractors’ Activities in 2012 and 2013, a Data Compendium (May 2016)
- GAO, Medicare Fee-For-Service: Opportunities Remain to Improve Appeals Process (May 2016)
- GAO, FDA Needs More Strategic Planning to Guide its Scientific Initiatives (May 2016)
- OIG, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure (May 2016)
- OIG, Observations from Our Review of CMS’s Administration of the First Performance Year of the Pioneer Accountable Care Organization Payment Model (May 2016)
- OIG, Notice of Modification of OIG Advisory Opinion 10-07 (May 12, 2016)
- OIG, Semiannual Report to Congress: October 1, 2015 to March 31, 2016 (May 2016)
- OIG, OIG Advisory Opinion No. 16-06 (May 9, 2016)
- HHS/CDCP, Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey 2015 (May 2016)
- OIG, Incomplete and Inaccurate Licensure Data Allowed Some Suppliers in Round 2 of the Durable Medical Equipment Competitive Bidding Program that did Not Have Required Licenses (May 2016)
- OIG, U.S. Departments of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 But Did Not Fully Comply for Fiscal Year 2015 (May 2016)
- OIG, Medicaid Enhanced Provider Enrollment Screenings Have Not Been Fully Implemented (May 2016)
- OIG, OIG Advisory Opinion No. 16-05 (May 3, 2016)
- OIG, Inconsistencies in State Implementation of Correct Coding Edits May Allow Improper Medicaid Payments (April 2016)
- OIG, Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2014 (April 2016)
- OIG, Enhanced Enrollment Screening of Medicare Providers: Early Implementation Results (April 2016)
- OIG, OIG Advisory Opinion No. 16-04 (Apr. 19, 2016)
- OIG, Criteria for implementing section 1128(b)(7) exclusion authority (Apr. 18, 2016)
- CMS, Quality Payment Program,, Medicare Access and CHIP Reauthorization (Apr. 16, 2016)
- GAO, Medicare: Claim Review Could Be Improved with Additional Prepayment Reviews and Better Data (Apr. 2016)
- OIG, Compendium of Unimplemented Recommendations (Apr. 2016)
- CMS, Comprehensive Primary Care Plus, Request for Applications, Solicitation for Payer and Memorandum of Understanding (Apr. 1, 2016)
- OIG, OIG Advisory Opinion No. 16-03 (Mar. 18, 2016)
- OIG, Opportunities for Program Improvements to States’ Withdrawals of Federal Medicaid Funds (Mar. 2016)
- CMS, Next Generation ACO Model, Request for Applications (Mar. 2016)
- AHRQ, Confidential Physician Feedback Reports (Mar. 2016)
- OIG, The Medicare Contractors for Jurisdiction E Overpaid Claims for Replaced Cardiac Medical Devices When Hospitals Had Not Reported Manufacturer Credits (Mar. 2016)
- OIG, Review of the Department of Health and Human Services’ Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2015 181530300 (Mar. 2016)
- HHS, Health Insurance Coverage and the Affordable Care Act, 2010-2016 (Mar. 3, 2016)
- OIG, OIG Advisory Opinion No. 16-02 (Mar. 1, 2016)
- CMS, Delay in Enforcement of the Medicare Part D Prescriber Enrollment Requirement to February 1, 2017 01 16 (Mar. 1, 2016)
- CMS, RE: Availability of HITECH Administrative Matching Funds to Help Professionals and Hospitals Eligible for Medicaid EHR Incentive Payments Connect to Other Medicaid Providers (Feb. 29, 2016)
- HHS, Fact Sheet: Commitments from health care industry to make electronic health records work better for patients and providers (Feb. 29, 2016)
- HHS and DOJ, Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2015 (Feb. 2016)
- CMS, Notice of Imposition of Immediate Intermediate Sanctions (Suspension of Enrollment and Marketing) for Medicare Advantage-Prescription Drug Contract Number: H2962 (Feb. 26, 2016)
- GAO, CMS Should Act to Strengthen Enrollment Controls and Manage Fraud Risk (Feb. 2016)
- CMS, 2017 Medicare EHR Incentive Program Payment Adjustment Hardship Exception Application Instructions, 2017 Medicare EHR Incentive Program Payment Adjustment Hardship Application, Medicare EHR Incentive Program 2015 Payment Adjustment Application for Hardship Exception for Critical Access Hospitals (CAHs)
- OIG, CMS Management of the Federal Marketplace (Feb. 2016)
- CMS, Advance Notice of Methodological Changes for CY 2017 for Medicare Advantage Capitation Rates, Part C and Part D Payment Policies and 2017 Call Letter (Feb. 19, 2016)
- CBO, S. 2368, Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act of 2015 (Feb. 16, 2016)
- CMS, MLN Matters: Guidance on the Physician Quality Reporting System (PQRS) 2014 Reporting Year and 2016 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs) (Feb. 2016)
- SAMHSA, Parity of Mental Health and Substance Use Benefits with Other Benefits: Using Your Employer-Sponsored Health Plan to Cover Services (Feb. 2016)
- CMS, The Transitional Reinsurance Program’s Contribution Collections for the 2015 Benefit Year (Feb. 12, 2016)
- CBO, Private Health Insurance Premiums and Federal Policy (Feb. 2016)
- CMS, Core Quality Measures, Consensus Core Set for ACO and PCMH Primary Care Measures, Version 1.0, Cardiovascular Measures, Version 1.0, Gastroenterology Measures, Version 1.0, HIV/Hep C Core Measures, Version 1.0, Medical Oncology Measures, Version 1.0, OB/GYN Measures, Version 1.0, and Orthopedic Measures, Version 1.0
- OIG, MFCU Statistical Data for Fiscal Year 2015 (February 2016)
- OIG, California State Medicaid Fraud Control Unit: 2015 Onsite Review (Feb. 2016)
- OIG, Testimony Before the U.S. House of Representatives Committee on Energy and Commerce: Subcommittee on Health (Feb. 10, 2016)
- CMS, Call Center Monitoring (Feb. 3, 2016)
- OIG, Justification of Estimates for Appropriations Committees (Feb. 2016)
- CDPH, Health Facility License Fees and Nursing Home Administrator Program Fees (2016-17) (Feb. 1, 2016)
- OIG, We Could Not Determine Whether West Virginia’s Severance and Business Privilege Tax on Behavioral Health Services Is a Permissible Health-Care-Related Tax (Jan. 2016)
- CMS, Alternative Benefit Plan Conforming Changes (Jan. 28, 2016)
- GAO, Medicaid: Efforts to Exclude Nonemergency Transportation, but Raise Issues for Expanded Coverage (Jan. 2016)
- Affordable Care Act Federal Upper Limit Methodology and Data Elements Guide and data (Jan. 28, 2016)
- CBO, The Budget and Economic Outlook 2016-2026 (Jan. 2016)
- FDA, Draft Guidance for Industry and Food and Drug Administration Staff (Jan. 22, 2016)
- CMS, Medicare EHR Incentive Program 2015 Payment Adjustment Application for Hardship Exception for Critical Access Hospitals (CAHs) (Jan. 2016)
- OIG, Inadequate Security Management Practices Left Utah Department of Health Sensitive Medicaid Data at Risk of Unauthorized Disclosure (Jan. 2016)
- CMS, 2017 Medicare EHR Incentive Program Payment Adjustment Hardship Exception Application (Jan. 2016)
- CMS, 2017 Medicare EHR Incentive Program Payment Adjustment Hardship Exception Application Instructions (Jan. 2016)
- OIG, Final Notice of Modification and Termination of OIG Advisory Opinion No. 08-17 (Jan. 20, 2016)
- IRS, How to Report Form 1095-B (Jan. 2016)
- OIG, Final Notice of Modification and Termination of OIG Advisory Opinion No. 10-06 (Jan. 20, 2016)
- OIG, Most Children With Medicaid in Four States Are Not Receiving Required Dental Services (Jan. 2016)
- OIG, Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (Jan. 12, 2016)
- OIG, Administration Fiscal Year 2015 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (Jan. 12, 2016)
- Summary of Senate Health Committee Staff Draft: Bipartisan Legislation to Improve Health Information Technology for Patients and Families (Jan. 2016)
- OIG, OIG Advisory Opinion No. 15-16 (Jan. 4, 2016)
- OIG, National Background Check Program for Long-Term-Care Employees: Interim Report (Jan. 2016)
- CMS, Preliminary Findings from the Washington MFFS Demonstration (Jan. 4, 2016)
- OIG, California Claimed Unallowable Federal Medicaid Reimbursement By Not Billing Manufacturers for Rebates for Some Physician-Administered Drugs (Jan. 2016)
- OIG, OIG Advisory Opinion No. 15-17 (Jan. 4, 2016)
- CMS, Measurement, Monitoring, and Evaluation of the Financial Alignment Initiative for Medicare-Medicaid Enrollees (Jan. 4, 2016)
- IRS, Notice 2016-02 (Claiming the Health Coverage Tax Credits for 2014 and 2015) (Jan. 2016)
- IRS, Notice 2016-4 (Extension of the Due Dates for 2015 Information Reporting Under I.R.C. §§ 6055 and 6056) (Jan. 2016)
2015
- (Draft) Bipartisan Budget Act of 2015
- OIG, CMS Could Not Effective Ensure that Advance Premium Tax Credit Payments Made Under the Affordable Care Act Were Only For Enrollees Who Paid Their Premiums (Dec. 2015)
- IRS, Notice 2015-87, Further Guidance on the Application of the Group Health Plan Market Reform Provisions of the Affordable Care Act to Employer-Provided Health Coverage and on Certain Other Affordable Care Act Provisions (Dec. 2015)
- GAO, FDA Expedites Many Applications, But Data for Postapproval Oversight Need Improvement (Dec. 2015)
- GAO, Additional Oversight Needed of CMS’s Demonstration to Coordinate the Care of Dual-Eligible Beneficiaries (Dec. 2015)
- GAO, Medicaid Managed Care: Trends in Federal Spending and State Oversight of Costs and Enrollment (Dec. 2015)
- GAO, Medicare: Increasing Hospital-Physician Consolidation Needs for Payment Reform (Dec. 2015)
- GAO, Comprehensive Planning by HHS Needed to Meet National Needs (Dec. 2015)
- OIG, Notice of Modification of OIG Advisory Opinion No. 06-04 (Dec. 30, 2015)
- OIG, OIG Advisory Opinion No. 15-15 (Dec. 29, 2015)
- CMS, PECOS Technical Assistance Contact Information, PECOS for Physicians and Non-Physician Practitioners, PECOS Technical Assistance Contact Information, PECOS for Provider and Supplier Organization, PECOS FAQs, and Safeguard Your Identity and Privacy Using PECOS (Dec. 2015)
- CMS, Medicare Enrollment for Physicians and Other Part B Suppliers (Dec. 2015)
- CMS, Medicare Enrollment for Institutional Providers (Dec. 2015)
- CMS, Medicare Enrollment Guidelines for Order/Referring Providers (Dec. 2015)
- OIG, Notice of Modification of OIG Advisory Opinion No. 11-05 (Dec. 29, 2015)
- OIG, Notice of Modification of OIG Advisory Opinion No. 07-06 (Dec. 29, 2015)
- CMS, Draft 2017 Letter to Issuers in the Federally-facilitated Marketplaces (Dec. 23, 2015)
- OIG, Modification of OIG Advisory Opinion No. 06-13 (Dec. 16, 2015)
- OIG, Average Manufacturer Prices Increased Faster Than Inflation for Many Generic Drugs (Dec. 2015)
- CMS, Decision Memo for Positron Emission Tomography (NaF-18) to Identify Bone Metastasis of Cancer (CAG-00065R2) (Dec. 15, 2015)
- OIG, CMS Has Not Performed Required Closeouts of Contracts Worth Billions (Dec. 2015)
- HITPC, Report to Congress: Challenges and Barriers to Interoperability (Dec. 2015)
- OIG, Modifications of OIG Advisory Opinion No. 07-11 (Dec. 7, 2015)
- AHLA, CMS Revises Two-Midnight Rule to Allow An Exception for Part A Payment for Hospital Services Provided to Patients Requiring Inpatient Care for Less Than Two Midnights (Dec. 2015)
- IRS, 2015 Instructions for Forms 1094-B and 1095-B (Dec. 2015)
- IRS, 2015 Instructions for Forms 1094-B and 1095-B (Dec. 2015)
- IRS, Form 1094-B (2015)
- IRS, Form 1095-B (2015)
- CMS, Certification of Comparability of Pediatric Coverage Offered by Qualified Health Plans (Nov. 25, 2015)
- OIG, High-Risk Security Vulnerabilities Identified During Reviews of Information System General Controls at Three California Managed-Care Organizations Raise Concerns About the Integrity of Systems Used to Process Medicaid Claims (Nov. 2015)
- AHRQ, Telehealth: An Evidence Map for Decision-making and Appendixes (Nov. 2015)
- CMS, Pub. 100-04 Medicaid Claims Processing (Nov. 23, 2015)
- OIG, Semiannual Report to Congress (April 1 — September 30, 2015) (Nov. 2015)
- OIG, OIG Advisory Opinion 15-14 (Nov. 20, 2015)
- OIG, Part B Payments for 340B-Purchased Drugs (Nov. 2015)
- OIG, New Compliance Counsel Expert Retained by the DOJ Fraud Section (Nov. 3, 2015)
- OIG, Modification of OIG Advisory Opinion No. 07-18 (Nov. 2, 2015)
- OIG, Notice of Modification of OIG Advisory Opinion No. 06-10 (Nov. 2, 2015)
- CMS, Extension of California’s Section 1115 Demonstration Project (Oct. 31, 2015)
- GAO, Nursing Home Quality: CMS Should Continue to Improve Data and Oversight (Oct. 2015)
- CMS, Fact Sheet: Two-Midnight Rule (Oct. 30, 2015)
- OIG, Work Plan Fiscal Year 2016 (October 2015)
- MLN Matters, Medicare Fee-For-Service (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10) – A Re-Issue of MM7492 (Oct. 30, 2015)
- AHRQ, 2013 Annual Hospital-Acquired Condition Rate and Estimates of Cost Savings and Deaths Averted From 2010 to 2013 (Oct. 2015)
- DOL, FAQs about Affordable Care Act Implementation and Mental Health Parity Implementation (Oct. 23, 2015)
- OIG, OIG Advisory Opinion No. 15-13 (Oct. 21, 2015)
- CMS, Medicare Advance Beneficiary Notices (Oct. 2015)
- FTC, FTC Staff Guidance on Active Supervision of State Regulatory Boards Controlled by Market Participants (Oct. 2015)
- OIG, OIG Policy Reminder: Information Blocking and the Federal Anti-Kickback Statute (Oct. 6, 2015)
- AB 15 (End of Life) (Oct. 5, 2016)
- CMS, Federally-facilitated Marketplace and Federally-facilitated Small Business Health Options Program Enroll-ment Manual (October 1, 2015)
- GAO, Hospital Value-Based Purchasing: Initial Results Show Modest Effects on Medicare Payments and No Apparent Change in Quality-of Care Trends (Oct. 2015)
- OIG, The Medicare Payment System for Skilled Nursing Facilities Needs to be Reevaluated (Sept. 2015)
- OIG, The Medicare Payment System for Skilled Nursing Facilities Needs to be Reevaluated (Sept. 2015)
- OIG, CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services (Sept. 2015)
- OIG, Medicare Payments for Clinical Laboratory Tests in 2014: Baseline Data (Sept. 2015)
- OIG, OCR Should Strengthen its Oversight of Covered Entities’ Compliance with the HIPAA Privacy Standards (Sept. 2015)
- OIG, OCR Should Strengthen its Followup of Breaches of Patient Health Information Reported by Covered Entities (Sept. 2015)
- OIG, Recommendation Followup Memorandum Report: States’ Collection of Rebates for Drugs Paid Through Medcaid Managed Care Organization Has Improved (Sept. 16, 2015)
- DOJ, Individual Accountability for Corporate Wrongdoing (Sept. 9, 2015)
- ONC, Federal Health IT Strategic Plan, 2015-2020 (Sept. 2015)
- OIG, Questionable Billing for Medicare Ophthalmology Services (Sept. 2015)
- CMS, The CMS Equity Plan for Improving Quality in Medicare (Sept. 2015)
- IRS, Instructions for Forms 1094-C and 1095-C (Sept. 2015)
- IRS, Form 1094-C (Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns) (Sept. 2015)
- IRS, Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) (Sept. 2015)
- OIG, CMS Did Not Always Manage and Oversee Contractor Performance For the Federal Marketplace As Required By Federal Requirements and Contract Terms (Sept. 2015)
- CMS, 2015 Physician Quality Reporting System (PQRS): Implementation Guide (Sept. 2015)
- OIG, HHS Oversight of Grantees Could Be Improved Through Better Information Sharing (Sept. 2015)
- OIG, Providers Did Not Always Reconcile Patient Records With Credit Balances and Report and Return the Associated Medicaid Overpayments to State Agencies (Aug. 2015)
- GAO, Changes Needed to Improve CMS’s Recovery Audit Program Operations and Contractor Oversight (Aug. 2015)
- List of Proposed Essential Health Benefit Benchmark Plans for 2017 and Beyond (Sept. 2015)
- MedPac, Letter Re: CMS-1625-P (Aug. 18, 2015)
- GAO, The Range of Premiums and Plan Availability for Individuals in 2014 and 2015 671916 (Aug. 2015)
- OIG, Memorandum Report: Overlap Between Physician-Owned Hospitals and Physician-Owned Distributors (Aug. 13, 2015)
- FDA, Guidance for Entities Considering Whether to Register as Outsourcing Facilities Under Section 503B of the Federal Food, Drug, and Cosmetic Act (Aug. 2015)
- OIG, OIG Advisory Opinion No. 15-12 (Aug. 13, 2015)
- OIG, OIG Advisory Opinion No. 15-11 (Aug. 12, 2015)
- IRS, Draft General Rules and Specifications for Affordable Care Act Substitute Forms 1095-A, 1094-B, 1095-B, 1094-C and 1095-C (Aug. 11, 2015)
- IRS, Draft Instructions for Form 8853 (Aug. 10, 2015)
- IRS, Instructions for Forms 1094-C and 1095-C (draft) (Aug. 6, 2015)
- IRS, Instructions for Forms 1094-B and 1095-B (draft) (Aug. 6, 2015)
- IRS, Form 1095-C (draft) (Aug. 6, 2015)
- IRS, Form 1095-B (draft) (Aug. 6, 2015)
- OIG, Not All of the Federally Facilitated Marketplace’s Internal Controls Were Effective in Ensuring that Individuals Were Properly Determined Eligible for Qualified Health Plans and Insurance Affordability Programs (Aug. 2015)
- FDA, Draft Guidance for Industry and Food and Drug Administration Staff (July 2015)
- OIG, Memorandum Report: Performance Data for the Senior Medicare Patrol Projects: July 2015 Performance Report (July 29, 2015)
- GAO, Medicaid: Additional Reporting May Help CMS Oversee Prescription Drug Fraud Controls (July 2015)
- OIG, OIG Advisory Opinion No. 15-10 (July 28, 2015)
- IRS, Affordable Care Act (ACA) Information Returns (AIR) (July 28, 2015)
- OIG, Actual Enrollment and Profitability Was Lower than Projections Made by the Consumer Operated and Oriented Plans and Might Affect Their Ability to Repay Loans Provided Under the Affordable Care Act (July 2015)
- GAO, Medicaid, Key Issues Facing the Program (July 2015)
- IRS, Section 4980I — Excise Tax on High Cost Employer Sponsored Health Plan (July 2015)
- CMS, ICD-10 FAQs (July 2015)
- OIG, OIG Advisory Opinion No. 15-09 (July 23, 2015)
- GAO, Patient Protection and Affordable Care Act: Observations on 18 Undercover Tests of Enrollment Controls for Health-Care Coverage and Consumer Subsidies Provided under the Act (July 16, 2015)
- 2015 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds (July 2015)
- IRS, Application of the Patient-Centered Outcomes Research Trust Fund Fee to Common Types of Health Coverage or Arrangements (July 2015)
- White House, Precision Medicine Initiative: Proposed Privacy and Trust Principles (July 8, 2015)
- CMS, 2014 Actuarial Report on the Financial Outlook for Medicaid (July 2015)
- IRS, The IRS’s Administration of the Affordable Care Act Has Gone Well Over all, But Some Glitches Have Arisen (July 2015)
- IRS, Patient-Centered Outreach Research Institute Filing Due Dates and Applicable Rates (July 2015)
- CMS, ICD-10, FAQs (July 2015)
- CMS, Addendum to 2015 CMS QRDA Implementation Guide for Eligible Professional Programs and Hospital Quality Reporting (HQR) (July 2015)
- IRS, Form 720 (Quarterly Federal Excise Tax Return) (2015)
- CMS, Addendum to 2015 CMS QRDA Implementation Guide for Eligible Professional Programs and Hospital Quality Reporting (July 2015)
- CMS, Update to Ambulatory Surgical Center (ASC) Infection Control Surveyor Worksheet (June 25, 2015)
- OIG, OIG Advisory Opinion No. 15-08 (June 19, 2015)
- MedPAC, Health Care Spending and the Medicare Program (June 2015)
- OIG, Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D (June 2015)
- FDA, Draft Guidance for IDE Sponsors, Sponsor-Investigators and Food and Drug Administration Staff (June 18, 2015)
- OIG, Ensuring the Integrity of Medicare Part D (June 2015)
- GAO, Behavioral Health: Options for Low-Income Adults to Receive Treatment in Selected States (June 2015)
- IRS, Notice 2015-46, Clarifications to the Requirement in the Treasury Regulations Under § 501(r)(4) that a Hospital Facility’s Financial Assistance Policy Include a List of Providers (June 26, 2015)
- CMS, Transitional Reinsurance Program: Pro Rata Adjustment to the National Coinsurance Rate for the 2014 Benefit Year (June 17, 2015)
- IRS, 2015 Report of Recommendations (Advisory Committee on Tax Exempt and Government Entities) (June 17, 2015)
- MedPAC, Medicare and the Health Care Delivery System (June 2015)
- CMS, Distribution of Information Regarding Advance Payments of the Premium Tax Credit (APTC) and Cost-Sharing Reductions (CSR) in Federal Standard Notices for Coverage Offered through the Federally-facilitated Marketplaces (June 12, 2015)
- OIG, Fraud Alert: Physician Compensation Arrangements may Result in Significant Liability (June 9, 2015)
- MedPAC, Letter to CMS (June 9, 2015)
- OIG, OIG Advisory Opinion No. 15-07 (June 4, 2015)
- OIG, CMS’s Internal Controls Did Not Effectively Ensure the Accuracy of Aggregate Financial Assistance Payments Made to Qualified Health Plan Issuers Under the Affordable Care Act (June 2015)
- CMS, FAQs on the Clarification of the Use of 1311 Funds for Establishment Activities (June 2015)
- OIG, OIG Advisory Opinion No. 15-06 (June 4, 2015)
- Treasury Inspector General, Affordable Care Act: Interim Results of the Internal Revenue Service Verification of Premium Tax Credit Claims (May 29, 2015)
- DHCS, Fact Sheet: Medi-Cal Diagnosis Related Group Payment Method Update for Fiscal Year (FY) 2015-16 (May 28, 2015)
- CMS, CCIIO Technical Guidance (CCIIO 2015—0001): Questions and Answers Regarding the Medical Loss Ratio (MLR) Reporting and Rebate Requirements (May 27, 2015)
- HHS/DOL, FAQs About Affordable Care Act Implementation (Part XXVII) (May 26, 2015)
- GAO, Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy (May 2015)
- HHS, Chronic Care Management Services (May 2015)
- OIG, Fiscal Year 2015 Work Plan (Mid Year Update) (May 2015)
- OIG, Questionable Billing for Medicaid Pediatric Dental Services in California (May 2015)
- State of California, (Draft) Medi-Cal Superior Systems Waiver Comprehensive Renewal (May 2015)
- CMS, Meaningful Use Proposed Rules Overview (May 5, 2015)
- CMS, Open Door Forum: Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program (May 14, 2015)
- CMS, Information Collection Tool for Beneficiaries Enrolled in Medicare Part D Plans (May 6, 2015)
- OIG, Incorrect Place-of_Service Claims Resulted in Potential Medicare Overpayments Costing Millions (May 2015)
- IRS, Affordable Care Act Information Returns (Apr. 30, 2015)
- IRS, Publication 5165 (Early Look) – Guide for Electronically Filing Affordable Care Act information Returns for Software Developers and Transmitters (Draft) (April 2015)
- HealthIT, Guide to Privacy and Security of Electronic Health Information (Apr. 2015)
- OIG, OIG Advisory Opinion 15-05 (Apr. 29, 2015)
- OIG, California Implemented Security Controls over the Web Site and Databases for Its Health Insurance Exchange But Could Improve Protection of Personally Identifiable Information (April 2014)
- FDA, Acceptance of Medical Device Clinical Data from Studies Conducted Outside the United States (Draft) (Apr. 22, 2015)
- OIG, Recommendations Followup Memorandum Report: Implementing OIG Recommendations Could Have Reduced Payments for DME Infusion Drugs By Hundreds of Millions of Dollars (Apr.21, 2015)
- OIG, Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2013 (Apr. 2015)
- CMS, Medicare Fee-For Service Provider Utilization & Payment Data; Part D Prescriber (Apr. 7, 2015)
- OIG, Medicaid Rebates for Brand-Name Drugs Exceeded Part D Rebates By A Substantial Margin (Apr. 2015)
- OIG, Medicaid Fraud Control Units, Fiscal Year 2014 Annual Report (Apr. 2015)
- OIG, Practical Guidance for Health Care Governing Boards on Compliance Oversight (Apr. 2015)
- GAO, 2015 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits (Apr. 2015)
- MLN Matters, April 2015 Update of the Ambulatory Surgical Center (ASC) Payment System (Apr. 1, 2015)
- FDA, Use of Electronic Informed Consent in Clinical Investigations (Draft) (Mar. 2015)
- IRS, Hardship Exemption Information (Mar. 2015)
- IRS, Exemption information if you’re eligible to get services from an Indian health care provider (Mar. 2015)
- IRS, Exemption information if your state didn’t expand Medicaid (Mar. 2015)
- IRS, Exemption information if you had a gap in health coverage (Mar. 2015)
- IRS, Exemption information if you couldn’t afford health coverage (Mar. 2015)
- IRS, Information about health insurance market exemptions (Mar. 2015)
- OIG, OIG Advisory Opinion No. 15-04 (Mar. 25, 2015)
- OIG, Fraud in Medicare Testimony (Mar. 24, 2015)
- OIG, Examining the 340(b) Drug Pricing Program Testimony (Mar. 24, 2015)
- CMS, Instructions for Disclosures of Noncompliance Arising Solely from a Violation of 42 C.F.R. § 411.362(b)(3)(ii)(C) (Mar. 2015)
- AOPA, Estimated Impact of Deferring Provider Payment for RAC Appeals Until After Administrative Law Judge (ALJ) (Level 3) Determinations (Mar. 19, 2015)
- HHS and DOJ, Health Care Fraud and Abuse Control Program FY 2014 (Mar. 19, 2015)
- OIG, Compendium of Unimplemented Recommendations (Mar. 2015)
- IRS, Health Savings Accounts and Other Tax-Favored Health Plans (Mar. 10, 2015)
- IRS, Notice 2015-17: Guidance on the Application of Code § 4980D to Certain Types of Health Coverage Reimbursement Arrangements
- IRS, Notice 2013-54: Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements
- IRS, Rev. Proc. 2015-21 (Mar. 2015)
- OIG, Medicare Could Have Saved Billions at Critical Access Hospitals if Swing-Bed Services Were Reimbursed Using the Skilled Nursing Facility Prospective Payment System Rates (Mar. 2015)
- CMS, 2015 National Impact Assessment of the Center for Medicare & Medicaid Services (CMS) Quality Measures Report (Mar. 2, 2015)
- CMS, 2015 Value Modifier Results (Mar. 2015)
- CMS, Technical Notes for HCAHPS Star Ratings
- OIG, OIG Advisory Opinion No. 15-03 (Mar. 2, 2015)
- CMS, California State Plan Amendment (SPA) 13-0027-MM7 (Feb. 27, 2015)
- MLN Matters, Denial Letters for Religious Non-medical Health Care Institution Services Not Covered by Medicare (Revised Feb. 25, 2015)
- IRS, Section 4980I — Excise Tax on High Cost Employer-Sponsored Health Coverage (Feb. 23, 2015)
- CMS, CMS Announces Special Enrollment Period for Tax Season (Feb. 20, 2015)
- OIG, Health Reform Plan Oversight (Feb. 2015)
- OIG, Advisory Opinion No. 15-02 (Feb. 13, 2015)
- FDA, Draft Memorandum of Understanding Addressing Certain Distributions of Compounded Human Drug Products between [State] and the FDA (Feb. 2015)
- FDA, Adverse Event Reporting for Outsourcing Facilities Under Section 503B of the Federal Food, Drug, and Cosmetic Act (Feb. 2015)
- FDA, Mixing, Diluting, or Repackaging Biological Products Outside the Scope of an Approved Biologics License Application (Feb. 2015)
- FDA, Repackaging of Certain Human Drug Products by Pharmacies and Outsourcing Facilities (Feb. 2015)
- FDA, For Entities Considering Whether to Register As Outsourcing Facilities Under Section 503B of the Federal Food, Drug, and Cosmetic Act (Feb. 2015)
- CMS, Revised Centers for Medicare & Medicaid Services (CMS) 855R Application — Reassignment of Medicare Benefits (June 1, 2015)
- Notice 2013-54, Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements (Jan. 2015)
- CMS, CMS Manual System Pub. 1008-08, Medicare Program Integrity (Feb. 24, 2015)
- Health Care & Taxes
- OIG, Advisory Opinion No. 15-01 (Feb. 2, 2015)
- CMS, Revised Guidance Related to New & Revised Regulations for Hospitals, Ambulatory Surgical Centers (ASCs), Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) (Jan. 30, 2015)
- MLN Matters, Opting out of Medicare and/or Electing to Order and Certify Items and Services to Medicare Beneficiaries (Jan. 14, 2015)
- OIG, Quality Improvement Organizations Provide Support to More Than Half of Hospital But Overlap With Other Programs (Jan. 2015)
- OIG, Justification of Estimates for Appropriations Committees (Fiscal Year 2016)
- IRS, Rev. Proc. 2015-15 (Examination of returns and claims for refund, credit, or abatement; determination of corrected tax liability) (Jan. 2015)
- MLN Matters, January 2015 Update of the Ambulatory Surgical Center (ASC) Payment System (Jan. 5, 2015)
- IRS, Health Care Law: What’s New for Individual & Families (Publication 5187)
- IRS, Form 8965 (Health Coverage Exemptions)
- IRS, Form 8962 (Premium Tax Credit)
- IRS, Form 1095-A (Health Insurance Marketplace Statement)
- CMS, Medicaid Managed Care Marketing Regulations Frequently Asked Questions (Jan. 16, 2015)
- OIG, Advisory Opinion No. 14-11 (Jan. 5, 2015)
- OIG, Federal Marketplace: Inadequacies in Contract Planning and Procurement (Jan. 2015)
- MLN Matters, January 2015 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Jan. 1, 2015)
- MLN Matters, 2015 Update of the Medicare Benefit Policy Manual, Chapter 13 – Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services (Jan. 1, 2015)
- MLN Matters, Calendar Year (CY) 2015 Rural Health Clinic (RHC) and Federally Qualified Health Centers (FQHC) Updates: Payment Rate Increases for RHCs and FQHCs Billing Under the All-Inclusive Rate System (AIR), and Urban and Rural Designations for FQHCs Billing Under the AIR (Jan. 1, 2015)
2014
- CMS, CMS Manual System Pub. 100-08 Medicare Program Integrity (Dec. 29, 2014)
- OIG, Access to Care: Provider Availability in Medicaid Managed Care (Dec. 2014)
- HHS, Suicide Assessment Five-Step Evaluation and Triage (Handout)
- CMS, Emergency Medical Treatment and Active Labor Act (EMTALA) Requirements and Implications Related to Ebola Virus Disease (Nov. 21, 2014)
- OIG, Fiscal Year 2014 Top Management and Performance Challenges Identified by the OIG (Nov. 2014)
- OIG, Recommendations Followup Memorandum Report: CMS Needs to Do More To Improve Medicaid Children’s Utilization of Preventative Screening Services (Nov. 12, 2014)
- DOL, Technical Release 2014-01, Guidance on State Regulation of Stop-Loss Insurance (Nov. 6, 2014)
- OCR, HIPAA Privacy in Emergency Situations (Nov. 2014)
- CDPH, SB 1276: Hospital Fair Billing Policies: Charity Care and Discount Payment Plans (Nov. 3, 2014)
- CDC, Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure (Nov. 3, 2014)
- HHS, Group Health Plans that Fail to Cover In-Patient Hospitalization Services, Notice 2014-69 (Nov. 2014)
- MMRR, The Impact of Hospital-Acquired Conditions on Medicare Program Payments (Oct. 2014)
- GAO, Compound Drugs: Payment Practices Vary across Public Programs and Private Insurers, and Medicare Part B Policy Should Be Clarified (Oct. 2014)
- OIG, 2015 Work Plan (Oct. 2014)
- OIG, 2015 Work Plan Medicare Paid for HIV Drugs for Deceased Beneficiaries (Oct. 2014)
- OIG, Medicare Beneficiaries Paid Nearly Half of the Costs for Outpatient Services at Critical Access Hospitals (Oct. 2014)
- GAO, Health Care Transparency: Actions Needed to Improve Cost and Quality Information for Consumers (October 21, 2014)
- HCUP, Statistical Brief 182, Characteristics of Medicaid and Uninsured Hospitalizations, 2012 (Oct. 2014)
- OIG, OIG Advisory Opinion No. 14-10 (Oct. 21, 2014)
- CMS, Medicare National Coverage Determinations (NCD) Coding Policy Manual and Change Report (Oct. 2014)
- OIG, OIG Advisory Opinion No. 14-09 (Oct. 14, 2014)
- CMS, Swing Bed Services (Oct. 1, 2014)
- OIG, OIG Advisory Opinion No. 14-08 (Sept. 24, 2014)
- HHS, National Quality Strategy, Working for Quality (Sept. 2014)
- ASPE, Issue Brief: Impact of Insurance Expansion on Hospital Uncompensated Care Costs in 2014 (Sept. 24, 2014)
- AHRQ, H-CUP, Trends in Emergency Department Visits, 2006-2011 (Sept. 2014)
- CMS, Revised Guidance Related to new & Revised Hospital Governing Body and Medical Staff Regulations (Sept. 15, 2014)
- OIG, State Standards for Access to Care in Medicaid Managed Care (Sept. 2014)
- OIG, Special Advisory Bulletin — Pharmaceutical Manufacturer Copayment Coupon (Sept. 2014)
- MLN Matters, Examining the Difference between a National Provider Identifier (NPI) and a Provider Transaction Access Number (PTAN) (Sept. 5, 2014)
- OIG, Medicare Part B Prescription Drug Dispensing and Supplying Fee Payment Rates (Sept. 2014)
- OIG, Health Insurance Marketplaces Generally Protected Personally Identifiable Information But Could Improve Certain Information Security Controls (Sept. 2014)
- OIG, CMS Has Yet To Enforce a Statutory Provision Related To Rural Health Clinics (Sept. 2014)
- MLN Matters, 2014-2015 Influenza (Flu) Resources for Health Care Professionals (Sept. 2014)
- AHRQ, Hospital Guide to Reducing Medicaid Readmissions (Aug. 2014)
- AHRQ, Hospital Guide to Reducing Medicaid Readmissions, Toolbox (Aug. 2014)
- IRS, Draft 1094-C and 1095-C Forms (Aug. 28, 2014)
- MLN Matters, Medicare Billing: 8371 and Form CMS-1450 (Aug. 2014)
- Medicare & Medicaid Research Review, Risk Transfer Formula for Individual and Small Group Markets Under the Affordable Care Act (2014: Vol. 4, No. 3)
- Medicare & Medicaid Research Review, The HSS-HCC Risk Adjustment Model for Individual and Small Group Markets Under the Affordable Care Act (2014: Vol. 4, No. 3)
- Medicare & Medicaid Research Review, Affordable Care Act Risk Adjustment: Overview, Context, and Challenges (2014: Vol. 4, No. 3)
- HCUP, 30-Day Readmission Rates to U.S. Hospitals (data from 2010)
- HCUP, The Top Five Most Expensive Conditions Treated in U.S. Hospitals (2011 data)
- HCUP, Adverse Drug Events Occurring in U.S. Hospitals (2011 data)
- IRS, Memorandum in Support of IRS Form 13909 Tax Exempt Organization Complaint (Aug. 25, 2014)
- OIG, OIG Advisory Opinion No. 14-07 (Aug. 25, 2014)
- CMS, Update — Inpatient Psychiatric Facilities Prospective Payment System (FY) 2015 (Aug. 22, 2014)
- CMS, CMS Manual System, Pub. 100-04, Medicare Claims Processing, Reporting the Service Location National Provider Identifier (NPI) on Anti-Markup and Reference Laboratory Claims (Aug. 22, 2014)
- OIG, OIG Advisory Opinion No. 14-06 (Aug. 15, 2014)
- AHRQ, Hospital Guide to Reducing Medicaid Readmissions (Aug. 2014)
- OIG, The Office of the National Coordinator for Health Information Technology’s Oversight of the Testing and Certification of Electronic Records (August 2014)
- OIG, OIG Advisory Opinion No. 14-05 (July 28, 2014)
- OIG, The Centers for Medicare & Medicaid Services Provided Medicare Part D Coverage to Beneficiaries Confined in Mental Health Facilities for Court-Ordered Purposes (July 2014)
- OIG, Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2012 (July 2014)
- OIG, Testimony of Kay Daly and Joyce Greenleaf re: Hearing on “Failure to Verify: Concerns Regarding PPACA’s Eligibility System” (July 16, 2014)
- OMHA, Statement of Nancy J. Griswold, Chief Administrative Law Judge, Office of Medicare Hearings and Appeals, “Office of Medicare Hearing and Appeals Workloads” (July 10, 2014)
- CMCS, Self-Direction Program Options for Medicaid Payments in the Implementation of the Fair Labor Standards Act Regulations Changes (July 3, 2014)
- CMS, Recovery Auditing in Medicare and Medicaid for Fiscal Year 2012
- AHRQ, Trends and Projections in Inpatient Hospital Costs and Utilization, 2003-2013 (July 2014)
- AHRQ, Trends and Projections in U.S. Hospital Costs by Patient Age, 2003–2013 (July 2014)
- OIG, Security Controls Over the Implementation of Personal Identity Verification Cards at the Department of Health and Human Services Were Inadequate due to Lack of Some Essential Information Security Requirements (July 2014)
- OIG, Questionable Billing for Medicare Part B Clinical Laboratory Services (July 2014)
- CBO, Payments of Penalties for Being Uninsured Under the Affordable Care Act (June 2014)
- CMS, Medicaid & CHIP: April 2014 Monthly Applications, Eligibility Determinations, and Enrollment Report (June 4, 2014)
- OIG, Marketplaces Faced Early Challenges Resolving Inconsistencies with Applicant Data (June 2014)
- CDPH, Centers for Medicare and Medicaid Services (CMS) Restraint/Seclusion Death Reporting Requirements (June 20, 2014)
- CMS Manual System, Submission of Community Mental Health Center (CMHC) Certifications of Compliance with Section 485.918(b)(1) (June 13, 2014)
- BLS, CONSUMER PRICE INDEX, LOS ANGELES AREA – MAY 2014
- OIG, Special Fraud Alert: Laboratory Payments to Referring Physicians (June 25, 2014)
- CMS, Hospital Restraint/Seclusion Death Reporting (May 2014)
- CMS Manual System, New Guidance Added to Chapter 7 – Survey and Enforcement Process for Skilled Nursing Facilities and Nursing Facilities (June 12, 2014)
- CMS Form, REPORT OF A HOSPITAL DEATH ASSOCIATED WITH RESTRAINT OR SECLUSION
- OCR, Annual Report to Congress on Breaches of Unsecured Protected Health Information (Calendar Years 2011 and 2012)
- MedPac Report to Congress and Fact Sheet (June 2014)
- OIG, Medicare Inappropriately Paid Hospitals’ Inpatient Claims Subject to the Post-acute Care Transfer Policy (May 2014)
- Memorandum Report: State Requirements for Conducting Background Checks on Home Health Agency Employees (from Acting Deputy Inspector General for Evaluation and Inspection) (May 29, 2014)
- HRSA-14-148, Fiscal Year 2014 Affordable Care Act Health Center Expanded Services (June 2014)
- AHRQ, National Healthcare Disparities Report (May 2014)
- AHRQ, National Healthcare Quality Report (May 2014)
- CMS Policy Letter and New Form for Restraint / Seclusion Death Reporting (May 2014)
- OIG, Medicare and Beneficiaries Could Save Billions if CMS Reduces Hospital Outpatient Department Payment Rates for ASCs (Apr. 2014)
- OIG, Supplemental Special Advisory Bulletin: Independent Charity Patient Assistance Programs (May 2014)
- Agency for Healthcare Research and Quality, Hospital Survey on Patient Safety Culture: 2014 User Comparative Database Report (Apr. 2014)
- IRS, Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements (Sept. 2013)
- OIG, Guidance for Submitting a Contractor Self-Disclosure (April 2014)
- OIG, HHS OIG Contractor Self-Disclosure Form
- Agency for Healthcare Research and Quality, Hospital Safety on Patient Safety Culture (Apr. 2014)
- OIG, Vulnerabilities in the HHS Small Business Innovation Research Program (Apr. 2014)
- CMS, Additional Information of the DSH Reporting and Audit Requirements – Part 2 (Apr. 2014)
- CBO, Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act (Apr. 2014)
- OIG, Compendium of Priority Recommendations (Mar. 2014)
- CMS, Extended Transition to Affordable Care Act-Compliant Policies (Mar. 5, 2014)
- OIG, Medicaid Fraud Control Units, Fiscal Year 2013 Annual Report (Mar. 2014)
- OIG, Advisory Opinion No. 14-02 (Feb. 20, 2014)
- CMS, Open Payments: Creating Public Transparency Into Industry-Physician Financial Relationships (Feb. 2014)
- HHS/DOJ, Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2013 (Feb. 2014)
- CMS, RAC Program Improvements (Feb. 2014)
- CMS, RAC Program Improvements (Feb. 18, 2014)
- CMS, 2013 CMS Statistics
- OIG, Medicare an Beneficiaries Could Realize Substantial Savings if the DRG Window Were Expanded (Feb. 2014)
- OIG, Work Plan for Fiscal Year 2014
- CMS, Reviewing Hospital Claims for Patient Status: Admissions On or After October 1, 2013 (Jan. 31, 2014)
- CMS, Reducing Nonurgent Use of Emergency Departments and Improving Appropriate Care in Appropriate Settings (Jan. 16, 2014)
- OIG, Local Coverage Determinations Create Inconsistency in Medicare Coverage (Jan. 2014)
- OIG, Medicare Administrative Contractors’ Performance (Jan. 2014)
- IRS, Notice 2014-3, Proposed Procedures for Charitable Hospitals to Correct and Disclose Failures to Meet 501(r) (Jan. 2014)
2013
- OIG, Medicare Could Have Millions if Organ Procurement Organizations Had Correctly Reported Procurement of Double Lungs as Two Organs (Dec. 2013)
- CMS Manual System, Pub. 100-08, Medicare Program Integrity (Dec. 27, 2013)
- OIG, Semiannual Report to Congress April 2013 – September 2013 (Dec. 2013)
- IRS, 2013 Instructions for Schedule H (Form 990) (Draft, Dec. 2013)
- CMS, EMTALA Requirements and Conflicting Payor Requirements or Collection Practices (Dec. 13, 2013)
- HHS, Agency Financial Report FY 2013 (Dec. 2013)
- CMS, Proposed Payment Notice: Basic Health Program (Dec. 18, 2013)
- CMS, Items and Services That Are Not Covered Under the Medicare Program (Sept. 2013)
- CMS, Eligible Professional’s Guide to STAGE 2 of the EHR Incentive Programs (Sept. 2013)
- CMS, Reviewing Hospital Claims for Patient Status: Admissions On or After October 1, 2013 (Nov. 27, 2013)
- OIG, Noridian Healthcare Solutions, LLC, Inappropriately Paid Hospitals’ Medicare Claims Subject to the Postacute Care Transfer Policy in Jurisdiction 2 (Nov. 2013)
- IRS, Rules Relating to Additional Medicare Tax (Nov. 29, 2013): IRS, Rules Relating to Additional Medicare Tax
- CMS, Lessons from Early Medicaid Expansion Under Health Care Reform, Medicare & Medicaid Research Review 2013: Vol. 3, No. 4
- OIG, Biospecimen Research: Meeting Basic Human Subjects Protections Requirements and Communicating Informational Risks (Nov. 2013)
- OIG, Medicare Hospital Outlier Payments Warrant Increased Scrutiny (Nov. 2013)
- OIG, Advisory Opinion No. 13-15 (Nov. 12, 2013)
- OIG Advisory Opinion No. 13-14 (Oct. 22, 2013)
- OIG, Physician-Owned Distributors of Spinal Devices: Overview of Prevalence and Utilization (Oct. 2013)
- CMS Manual System, Pub. 100-08 Medicare Program (Effective Date: Oct. 3, 2013)
- CMS, Payment Adjustments Tool for eHealth Programs, eHealth Programs Eligibility, and eHealth Programs Timeline (September 2013)
- FDA, Mobile Medical Applications, Guidance for Industry and Food and Drug Administration Staff (Sept. 25, 2013)
- OIG, Memorandum Report: Utilization of Medicare Ambulance Transports, 2002-2011 (Sept. 24, 2013)
- IRS, Notice 2013-54 (Sept. 18, 2013): Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements
- U.S. DOL, Technical Release 2013-03 (Sept. 13, 2013): Application of Market Reform and other Provisions of the Affordable Care Act to HRAs, Health FSAs, and Certain other Employer Healthcare Arrangements
- FDA, Docket No. FDA-2005-P-0325, Response to petition expressing concern about the abuse potential of OxyContin and Palladone (Sept. 10, 2013)
- CMS, Hospital Inpatient Admission Order and Certification (Sept. 5, 2013)
- OIG, Medicare Recovery Audit Contractors and CMS’s Actions to Address Improper Payments, Referrals of Potential Fraud, and Performance (Aug. 2013)
- OIG, Frequency of Medicare Recertification Surveys for Hospices is Unimproved (Aug. 29, 2013)
- OIG (Aug. 21, 2013): OIG Advisory Opinion No. 13-11
- CMS Special Open Door Forum (Aug. 15, 2013): CMS Rule 1599-F: Inpatient Hospital Admission and Medical Review Criteria (2-Midnight Provision) and Part B Inpatient Billing in Hospitals
- FDA, Radio Frequency Wireless Technology in Medical Devices; Guidance of Industry and Food and Drug Administration Staff (Aug. 14, 2013)
- OIG, Most Critical Access Hospitals Would Not Meet the Location Requirements if Required to Re-Enroll in Medicare (Aug. 2013)
- CMS, Medicaid EHR Incentive Program: How Eligible Professionals Successfully Participate (Aug. 13, 2013)
- HHS Summaries for Hospital Value Based Purchasing Program, Section 1011, ICD-10 Classification Enhancements and ICD-10 Overview
- CMS, Bundling Post-Acute Care Services into MS-DRG Payments, Medicare & Medicaid Research Review, 2013: Volume 3, Number 3
- CMS, FY 2014 Final Rule Readmissions Supplemental Data (August 2013)
- CMS, Administrative Simplification and eHealth What Providers Need to Know about Administrative Simplification (July 30, 2013)
- OIG, Memorandum Report: Hospitals’ Use of Observation Stays and Short Inpatient Stays for Medicare Beneficiaries (July 29, 2013)
- CMS, What Providers Need to Know about CMS Quality Programs (July 16, 2013)
- CMS, Medicare & Medicaid EHR Incentive Programs: Stage 2, Payment Adjustments & Audits (June 12, 2013)
- CMS, CMS outlines plan to implement PPACA reductions in state allocations for DSH payments (May 21, 2013)
- DOL, Guidance on the Notice to Employees of Coverage Options Under Fair Labor Standards Act and Updated Model Election Notice (May 8, 2013)
- CMS, National Action Plan to Prevent Health Care-Associated Infections (Apr. 2013)
- CMS, Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Mar. 29, 2013)
- CMS, National Provider Call: Hospital Value-Based Purchasing; Fiscal Year 2015 Overview for Beneficiaries, Providers and Stakeholders (Mar. 14, 2013)
- CMS Ruling No. 1455-R (Mar. 13, 2013): Medicare Program; Part B Billing in Hospitals
- HHS Notice of Benefit and Payment Parameters for 2014 (Mar. 2013)
- CMS, Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide (Mar. 29, 2013)
- 2013 OIG Work Plan
- OIG’s Special Advisory Bulletin on the Effect of Exclusion from Participation in Federal Health Care Programs (May 8, 2013)
- OIG’s Provider Self-Disclosure Protocol (Apr. 17, 2013)
2012
- OIG, Compendium of Unimplemented Recommendations (Dec. 2012)
- U.S. Dept. of Commerce, Guidelines for Media Sanitization (Draft) (Sept. 2012)
- CMS, EHR Incentive Programs — White Paper (November 2012)