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Buyer Beware: CMS Finalizes Ownership Disclosure Requirements for Medicare Skilled Nursing Facilities and Medicaid Nursing Facilities

Hall Render

Finalized Revisions to Form CMS-855A For SNFs, the aforementioned data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”). For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency.

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New Medicare Disclosure Requirements for Skilled Nursing Facilities – Provider Enrollment Off-Cycle Revalidations – Watch for a Revalidation Request

Hall Render

Effective October 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) introduced significant updates to the CMS-855A form , specifically requiring a new Skilled Nursing Facility (“SNF”) Attachment for every SNF. Hall Render blog posts and articles are intended for informational purposes only.

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2024 Medicare Physician Fee Schedule Final Rule Makes Changes to Medicare Shared Savings Program

Hall Render

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024. CMS anticipates the changes will increase MSSP participation by 10% to 20%.

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The Power of Connection: How Clinical Data Registries, ACOs, and Payers Can Collaborate for Value-Based Care

MRO Compliance

The Role of Clinical Data Registries According to the latest information from the Centers for Medicare and Medicaid Services (CMS), 90% of payments are now linked to value, with 40% flowing through alternative payment models (APMs), showing the shift towards more cost-effective care driven by data from registries.

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Clear the Confusion about Medicare GA, GX, GY, GZ Modifiers

Medisys Compliance

Healthcare providers often get confused about the appropriate use of modifiers GA, GX, GY, and GZ while billing Medicare. GA modifier indicates that an Advance Beneficiary Notice (ABN) is on file and allows the provider to bill the patient if not covered by Medicare. Medicare does not pay for all health care costs.

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The Essentials of FWA Training in Healthcare

Compliancy Group

Compliance officers and other organizational leaders must be constantly vigilant of resource waste and the inappropriate and illegal use of funds from Medicare and other federal programs. Compliance with Medicare and other programs requires relevant staff to take regular fraud, waste, and abuse (FWA) training.

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CMS Issues Contract Year 2023 Final Rule for Medicare Advantage Organizations and Prescription Drug Sponsors

Healthcare Law Blog

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Refining Definition for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2