Search Results for: revocation

Home Health Revocation Actions by Medicare are Expanding Around the Country

(September 28, 2020):Last September, CMS published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process.” [1] Among its many changes, the Final Rule significantly expanded the reasons that may be asserted by the Centers for Medicare and Medicaid Services (CMS) when revoking a health care …

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Medicare Revocation Actions Related to Telemedicine Rising!

(September 25, 2020):  In recent years, many individuals (especially younger members of our work force) have embraced the chance to supplement their income through short-term engagements in the “gig economy.”  Notably, both professionals and non-professionals alike have found flexible, part-time opportunities online, allowing them to work remotely as independent contractors.  A number of physicians, nurse …

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Responding to a Medicare Revocation Action Effective Prior to November 4, 2019

(UPDATE:  March 9, 2020):  A Medicare revocation action can destroy the financial viability of your practice.  Moreover, effective November 4, 2019, the reasons for which a health care provider or supplier may have its Medicare billing privileges revoked have greatly expanded. Our article titled “42 CFR Sec. 424.535(a) Medicare Revocation Actions — Your Medicare Billing Privileges …

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42 CFR Sec. 424.535(a) Medicare Revocation Actions — Your Medicare Billing Privileges Can be Revoked For a Host of New Reasons. Are You Facing a Medicare Revocation Action? If so, You Must Act Fast to Preserve Your Appeal Rights.

(March 9, 2020):   Last September, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule titled “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process.”  The Final Rule under 42 CFR Sec. 424.535(a) was published in order to implement sections 1866(j)(5) and 1902(kk)(3) of the Social Security …

42 CFR Sec. 424.535(a) Medicare Revocation Actions — Your Medicare Billing Privileges Can be Revoked For a Host of New Reasons. Are You Facing a Medicare Revocation Action? If so, You Must Act Fast to Preserve Your Appeal Rights. Read More »

Medicare, Medicaid and CHIP Enrollment Revocation and Denial Authorities Have Expanded.  What Steps are You Taking to Reduce Your Level of Risk?

Big Changes to CMS Form 855 are on the Horizon (September 18, 2019):  On September 10, 2019, the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) published a Final Rule in the Federal Register entitled, “Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment …

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Revocation of Your Medicare Billing Privileges

The revocation of your Medicare billing privileges can subject your practice to financial ruin! (December 14, 2017):  The Centers for Medicare and Medicaid Services (CMS) has engaged various types of outside contracting entities to perform program integrity functions on behalf of the Medicare program.  At the present time, Uniform Program Integrity Contractors (UPICs) and Zone …

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Medicare Revocation Action: Steps for Avoiding and Appealing

(September 16, 2014): Consider the following scenario. You own a durable medical equipment (DME) company that you run out of a leased location in a local office building. Your customers are a mix of privately insured and Medicare/Medicaid beneficiaries. You’ve been in business for about 10 years, but money is tight and you need to …

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2022 Webinars

Wednesday, January 5, 2022 1 p.m. EST / Noon CST / 10:00 a.m. PST Vaccination Mandates In July 2021, President Biden began rolling out vaccination mandates covering federal employees and contractors. At that time, President Biden also called on employers to implement their own vaccination mandates. Since that time, thousands of organizations around the country …

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2021 Webinar

Wednesday, November 3, 2021 1 p.m. EST / Noon CST / 10:00 a.m. PST Using PEPPER to Assist You in Analyzing Your Home Health Claims Practices For several years now, CMS has been moving from a broad Probe and Educate program to a more targeted one. The Program for Evaluating Payment Patterns Electronic Report (PEPPER) …

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2019 TAHCH Webinar

Wednesday, November 6, 2019 The Importance of Incorporation and Asset Protection for Home Health and Hospice Agencies Unfortunately, sometimes even your best efforts are insufficient to keep an organization solvent. If your third-party billing company or your practice is forced into bankruptcy, can you be held liable? Are your personal assets at risk? What impact …

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