Implementation of new provider/supplier enrollment rules

In pursuit of its continuing goal of reducing fraud, waste, and abuse in federal health care programs, effective March 25, 2011, CMS will (1) begin determining the level of screening to be conducted during provider and supplier enrollment based on the level of risk posed to the Medicare system, and (2) require Medicare Administrative Contractors […]

CCH® Healthcare Compliance — 3/25/11

Implementation of new provider/supplier enrollment rules In pursuit of its continuing goal of reducing fraud, waste, and abuse in federal health care programs, effective March 25, 2011, CMS will (1) begin determining the level of screening to be conducted during provider and supplier enrollment based on the level of risk posed to the Medicare system, […]

Top management and performance challenges for HHS in 2011

The Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) has identified: (1) health care reform implementation; (2) the integrity of Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP); (3) the integrity of HHS public health and human services programs; and (4) cross-cutting departmentwide issues as the top management […]

CCH® Healthcare Compliance — 3/22/11

Top management and performance challenges for HHS in 2011 The Office of Inspector General (OIG) of the Department of Health & Human Services (HHS) has identified: (1) health care reform implementation; (2) the integrity of Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP); (3) the integrity of HHS public health and human services programs; […]

CCH® Medicaid — 3/17/11

Medicaid Court narrows settlement, limits EPSDT obligations A Tennessee federal court has ruled that several provisions of a 1998 consent decree should be vacated, limiting the enforcement of the state’s obligations under Medicaid’s early and periodic screening, diagnosis and treatment (EPDST) program. The ruling is preliminary because the parties requested time to try to settle […]

Court narrows settlement, limits EPSDT obligations

Medicaid Court narrows settlement, limits EPSDT obligations A Tennessee federal court has ruled that several provisions of a 1998 consent decree should be vacated, limiting the enforcement of the state’s obligations under Medicaid’s early and periodic screening, diagnosis and treatment (EPDST) program. The ruling is preliminary because the parties requested time to try to settle […]

Virginia seeks Supreme Court review of individual mandate

The Commonwealth of Virginia has sought U.S. Supreme Court review of a case pending in the U.S. Court of Appeals for the Fourth Circuit challenging the regulatory changes implemented by the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148), including the individual mandate to purchase health insurance. The Commonwealth of Virginia argues this challenge […]