November 17-24: CMS and OIG Issuances
Frequently asked questions
On November 21, CMS issued 41 new/updated frequently asked questions related to Medicare fee-for-service payment.
View the frequently asked questions.
CMS selects A/B Medicare administrative contractor (MAC) for New England
On November 19, CMS announced its selection of National Heritage Insurance Corporation (NHIC) as the A/B MAC for Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. As the A/B MAC contractor, NHIC will immediately begin implementation activities and will assume full responsibility for the claims processing work in its five-state jurisdiction no later than May 2009.
OIG issues report on Medicare billing for oxaliplatin at Franklin Memorial Hospital during calendar years (CY) 2004 and 2005
On November 19, the OIG issued a report in which it determined that Franklin Memorial billed Medicare incorrectly for oxaliplatin in CY 2004. These erroneous claims resulted in a net overbilling to Medicare of $97,968 for oxaliplatin furnished to hospital outpatients during CY 2004.
CMS issues proposed decision memo on surgery for diabetes
On November 17, CMS issued a proposed decision memo in which it proposed that type 2 diabetes mellitus is a comorbid condition related to obesity, as defined in NCD Manual 100.1 (Bariatric Surgery for Treatment of Morbid Obesity).
View the proposed decision memo.
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