Bi-weekly newsletter features news coverage and discussions on all the latest developments.
Learn More »Various provisions governing Medicare Part A provider reimbursement determinations, appeals before the intermediary hearing officers and the Provider Reimbursement Review Board (PRRB), and CMS Administrator review of PRRB decisions will become effective August 21, 2008, under a Final rule published by CMS on May 23, 2008.
Cost reporting. Under amendments to 42 C.F.R. §§405.1811(a)(1) and 405.1835(a)(1), effective for cost reporting periods ending on or after December 31, 2008, providers will have more time to evaluate whether they wish to file a cost report item under protest and eliminate the transitional administrative burden for intermediaries. Providers filing cost report items under protest will be required to explain their dissatisfaction with the amount of Medicare payment for the specific items at issue by stating why Medicare payment is incorrect for each disputed item. The regulatory amendments allow a provider to explain why it is unable to determine whether payment is correct as a result of not having access to underlying information.
Common ownership or control. A new §405.1835(b)(4) has been added to require a provider under common ownership or control to furnish the name and address of its parent corporation and submit a statement that, to the best of the provider's knowledge, no other provider to which it is related by common ownership or control has pending a request for a PRRB hearing on any of the same issues contained in the provider's hearing request. If a pending appeal exists, the provider must submit the provider name and provider number, as well as the case number for the appeal.
Current Health Care Compliance Letter subscribers, login in here.
The Health Care Compliance Letter features news coverage and discussions on all the latest developments — in ALL the critical areas of compliance — in an easy-to-read resource. In addition to cutting-edge news and guidance on complex issues surrounding Medicare/Medicaid reimbursement, you can look forward to "at-a-glance" information on other compliance "hot spots". Learn more or talk to your Sales Representative.
Expert Guide for the Compliance Maze
Health Care Compliance Professional’s ManualOffers guidance on applying the laws and regulations, and spells out practical, "how-to" compliance solutions. Endorsed by HCCA. Learn More » |
Journal of Health Care ComplianceProtect your organization with the Journal of Health Care Compliance, your first practical source of information on how to avoid government inquiries. Learn More » |