Since the CMS Preclusion list was announced in April 2018, and then published in January 2019, there has been confusion and questions regarding the list, its differences from the OIG Exclusion List, the size of the list, and who has access. Unfortunately, the publication of the list has added further complexity to the already complicated… more>>
Why is it Necessary to Screen Against the NPPES Registry? (December 7th, 2020): We are sometimes asked “Why do you screen against the National Plan and Provider Enumeration System (NPPES).” That is a great question. Many health care providers are only familiar with the exclusion database maintained by the Department of Health and Human Services (HHS),… more>>
(December 17, 2018): Texas Medicaid Exclusions will prevent the Texas Medicaid Program from paying for any item or service furnished directly or indirectly by individuals or entities that have been excluded from a State or Federal health care program. This results in a broad “Payment Prohibition” that is enforced by the Texas Health and Human… more>>
By Robert LilesHave you implemented the new “ Advance Beneficiary Notice of Noncoverage ” (ABN), required by the Centers for Medicare and Medicaid Services (CMS)? As CMS has noted, although the latest version of the form (ABN Form CMS-R-131) does not include any substantive changes, in accordance with Section 504 of the Rehabilitation Act of 1973, the… more>>
By Paul Weidenfeld and Catalina Jandorf The new Final Rule issued by CMS revising the conditions of participation for home health agencies (HHAs) requires that providers “must ensure” that agencies providing services under arrangement have not been excluded from Medicare, Medicaid or any other federal health care program. Effective July 17, 2017, the rule also states that… more>>