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CMS published a final rule on May 23, 2013 that implements new medical loss ratio requirements for the Medicare Advantage program and the Part D prescription drug program.

On October 29, 2013, CMS published a final rule establishing conditions of participation (CoPs) that community mental health centers (CMHCs) must meet to participate in the Medicare program.

CMS has updated the Medicare Program Integrity Manual to clarify that providers and suppliers have 45 days to produce documents in response to a pre-payment review Additional Documentation Request...

CMS has scheduled two calls to discuss the application process for the ACA’s Medicare Shared Savings Program for the January 1, 2014 start date.

On February 24, 2015, CMS published its final methodology and data sources for determining federal payment amounts for states that elect to use the Basic Health Program.

The ACA established the Early Retiree Reinsurance Program as a temporary program to reimburse employer and union sponsors of participating employment-based plans for a portion of the cost of health benefits for early retirees and their spouses, surviving spouses, and dependents.

Yesterday CMS submitted to the White House Office of Management and Budget a proposed rule to make changes to the Medicare Shared Savings Program.

On July 10, 2014, CMS is hosting a national provider call to discuss the new Five Star Rating system that will be added to Dialysis Facility Compare in October 2014.

CMS has published a notice announcing the annual adjustment in the amount in controversy (AIC) threshold amounts for Administrative Law Judge (ALJ) hearings and judicial review under the Medicare appeals process.

On December 2, 2013, CMS published a proposed rule that would establish 2015 payment parameters and oversight provisions for federally-facilitated Health Insurance Exchanges under the ACA.

CMS has published its proposed methodology and data sources necessary to determine federal payment amounts made to states that elect to establish a Basic Health Program (BHP) under the Affordable Care Act (ACA) to offer health benefits coverage to low-income individuals otherwise eligible to purchase coverage through Affordable Insurance Exchanges.

CMS has issued a proposed rule that would establish ACA Marketplace health plan payment parameters and essential benefit standards for 2016.

CMS published the proposed methodology for determining federal payment amounts for states that elect to use the Basic Health Program to offer health benefits to low-income individuals.

CMS has proposed its annual Notice of Benefit and Payment Parameters, which would apply to participation in Affordable Care Act (ACA) Health Insurance Marketplaces for 2018.

CMS is holding a public meeting on July 14, 2014 to receive comments on the appropriate basis for establishing payment amounts for new or substantially revised HCPCS codes being considered for Medicare payment under the clinical laboratory fee schedule for 2015.

CMS has published notices setting forth the criteria it will use to evaluate the effectiveness and efficiency of Quality Innovation Network.

CMS has posted the 2015 update to the alphanumeric HCPCS files.

CMS has released the Medicare DMEPOS fee schedule files that are effective January 1, 2015.