CMS Proposes Home Health Demonstration Project

The Centers for Medicare and Medicaid Services (CMS) seeks to develop and implement a Medicare demonstration project, which CMS believes will help assist in developing improved procedures for the identification, investigation, and prosecution of Medicare fraud occurring among Home Health Agencies (HHA) providing services to Medicare beneficiaries. This revised demonstration would help assist in developing…

TRICARE Update

On December 12, 2017, President Trump signed the National Defense Authorization Act (NDAA) into law. One important piece of legislation included in the NDAA directs the Department of Defense (DOD) to add physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) to the TRICARE program as an eligible provider of therapy services. Even though the…

Intent to Reopen a Denied Claim

The Centers for Medicare and Medicaid Services (CMS) has issued instructions for Medicare Administrative Contractors (MACs) to provide notification of the reopening process and to notify the provider or supplier of their intent to reopen a specific claim when requested documentation is received after a denial of the claim has been made. If the MACs…