Category Archives: MLN Matters

CMS Implements Fingerprinting Background Checks for New DME and Home Health Providers

Posted on April 23, 2014 by | Comments Off on CMS Implements Fingerprinting Background Checks for New DME and Home Health Providers

In a recently released MLN Matters (Number: SE1417), CMS announced that it is implementing the enhanced enrollment screening provisions of the Affordable Care Act (ACA) by requiring finger print based background checks for certain so called “high risk” providers. Currently this means that for newly enrolling Durable Medical Equipment, Prosthetic, Orthotic and Supplies (DMEPOS) suppliers and Home Health Agencies, individuals with a 5% or greater ownership interest in the provider or supplier will be subject to criminal background checks based on fingerprint identification. The procedure will also apply to providers that CMS has elevated to the high risk category pursuant to regulations. Affected providers will be notified by their MAC and be given 30 days to comply. The notification will identify contact information for the Fingerprint Based Background Check Contractor (FBBC). Continue reading →

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Posted in Community Based Care, Compliance Programs, Durable Medical Equipment, Employee Background Checks, Fraud and Abuse, General, Health & Human Services, Health Care, Health Care Providers, Health Reform, Home Health, Medicare, MLN Matters, Participation, Program Integrity, Provider Enrollment - Medicare, Regulation, Regulatory Compliance

Outpatient Rehabilitation Services: Complying with Documentation Requirements – MLN Fact Sheet Revised

Posted on November 17, 2011 by | Comments Off on Outpatient Rehabilitation Services: Complying with Documentation Requirements – MLN Fact Sheet Revised

CMS just released a revision to its MLN Factsheet (ICN 905365) –  Outpatient Rehabilitation Services: Complying with Documentation Requirements. The Factsheet is designed to provide rehabilitation providers with education on the  Comprehensive Error Rate Testing program errors related to outpatient rehabilitation therapy services.  It includes information on the documentation needed to support a claim submitted to Medicare for outpatient rehabilitation therapy services.

You can find a copy of the Factsheet here —–> MLN ICN 905365

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Posted in Fraud and Abuse, Medicare, MLN Matters, Occupational Therapy, Out-Patient Care, Physicial Therapy, Rehabilitation

A Summary of the Shared Savings Program with Accountable Care Organizations Final Rule – MLN Fact Sheet, ICN 907404

Posted on November 10, 2011 by | Comments Off on A Summary of the Shared Savings Program with Accountable Care Organizations Final Rule – MLN Fact Sheet, ICN 907404

 CMS’ Medicare Learning Network (MLN) just released Fact Sheet, ICN 907404, which is designed to provide education on the provisions of the final rule that implements the Medicare Shared Savings Program with Accountable Care Organizations (ACOs). It includes background, information on how ACOs impact beneficiaries, eligibility requirements to form an ACO, and information on monitoring and tying payment to improved care at lower costs.

You can get a copy of the Fact Sheet here —> ICN 907404

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Posted in Accountable Care Organizations, Health Care, Health Care Providers, Health Insurance, Health Reform, Medicare, MLN Matters, Payers

The Basics of Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program – MLN Fact Sheet ICN 907406

Posted on November 10, 2011 by | Comments Off on The Basics of Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program – MLN Fact Sheet ICN 907406

CMS’ Medicare Learning Network (MLN) just released Fact Sheet, ICN 907406, which is designed to provide education on Accountable Care Organizations (ACOs) under the Medicare Shared Savings Program. It includes a definition of an ACO, and information on how to participate in an ACO, how shared savings will work, how this program is aligned with other quality initiatives and how ACOs help doctors coordinate care.

Get a copy of the ACO Fact Sheet here —->ICN 907406

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Posted in Accountable Care Organizations, Health Care, Health Care Providers, Health Insurance, Health Reform, Medicare, MLN Matters, Payers

CMS Issues – MLN Matters on Expansion of Durable Medical Equipment (DME) Supplier Standards

Posted on February 2, 2011 by | Comments Off on CMS Issues – MLN Matters on Expansion of Durable Medical Equipment (DME) Supplier Standards

On 2/1/2011, CMS Issued MLN Matters No. SE1032 entitled “Expansion of Durable Medical Equipment (DME) Supplier Standards” 

The article provides information for DMEPOS suppliers on the new expanded CMS enrollment standards that suppliers must meet in order to establish and/or maintain billing privileges in the Medicare Program. Continue reading →

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Posted in Durable Medical Equipment, General, Medicare, MLN Matters, Provider Enrollment - Medicare, Supplier