Section 6409 of the Patient Protection and Affordable Care Act (PPACA) required CMS to develop a Medicare Self-Referral Disclosure Protocol (SRDP) to facilitate the resolution of potential Stark violations. The SRDP was published on September 23, 2010 with two caveats: 1. Despite the fact that potential violations or situations might violate more than just the Stark … Continue Reading
Section 6503 of the Patient Protection and Affordable Care Act (PPACA) requires that all billing agents, alternate payees, and clearinghouses that submit claims on behalf of health care providers must register with the state and the Secretary in a form specified by the Secretary. This provision will be effective January 1, 2011. Section 6505 also prohibits … Continue Reading
Section 6409 of the Patient Protection and Affordable Care Act (PPACA) requires the Secretary of Health and Human Services to develop a Medicare self-referral disclosure protocol, which is intended to allow providers to disclose self-referral violations and negotiate reduced civil penalties. The protocol shall be developed no later than six months following the date of enactment … Continue Reading
The Patient Protection and Affordable Care Act (PPACA) contains several provisions aimed to reduce fraud and abuse in home health and Durable Medical Equipment (DME) programs, which CMS and OIG consider to be high risk programs. Effective July 1, 2010, physicians who order covered home health or DME services must be enrolled in Medicare (§ 6405). … Continue Reading
Medicare Explains Timely Filing Requirements for Medicare Fee-For-Service Claims On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program. … Continue Reading
