CMS is hosting three listening sessions in January 2020 on how to “improve processes and enhance interactions” between the Medicare Administrative Contractors (MACs) and providers and suppliers, particularly with regard to operations, technology, and business functions. CMS also seeks ideas for ways to enhance beneficiary quality of care and the beneficiary customer service experience with
Contractors
GAO: CMS, MACs Should Bolster Provider Education to Cut Improper Medicare Payments
In 2016, an estimated $41.1 billion in improper Medicare fee-for-services payments were made to providers. The Centers for Medicare & Medicaid Services (CMS) believes that provider education plays an important role in ensuring payments are made properly; CMS has delegated authority for provider education to the Medicare Administrative Contractors (MACs).
In a recent report,…
Patient Access and Medicare Protection Act Signed Into Law; Includes Additional Medicare Reforms
On December 28, 2015, President Obama signed into law S. 2425, the Patient Access and Medicare Protection Act, which includes a number of Medicare provisions that were not included in the Consolidated Appropriations Act. Most significantly, the law:
- Extends the timeframe for eligible professionals and hospitals to apply for a hardship exception from meaningful
…
CMS Proposes Standards for Medicaid Recovery Audit Contractors (RACs)
On November 10, 2010, CMS published a proposed rule that would provide guidance to states on funding and operation for the Medicaid RAC program. By way of background, the ACA requires all states to contract with RACs to audit Medicaid claims, identify underpayments and overpayments, and recover overpayments or correct underpayments (similar to the…