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Final Medicare & Medicaid EHR Meaningful Use Rules Permit Deferrals, Exclusions
On July 16, 2010, the federal Centers for Medicare and Medicaid Services (CMS) released final rules for the Medicare and Medicaid electronic health record (EHR) meaningful use initiative program. The rules for the Stage 1 criteria of meaningful use permit eligible professionals and eligible hospitals the option to defer some objectives/measures and to permit exclusions for the applicability of some objectives/measures…On July 16, 2010, the federal Centers for Medicare and Medicaid Services (CMS) released final rules for the Medicare and Medicaid electronic health record (EHR) meaningful use initiative program. The rules for the Stage 1 criteria of meaningful use permit eligible professionals and eligible hospitals the option to defer some objectives/measures and to permit exclusions for the applicability of some objectives/measures…
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Managed Medicare & Medicaid Factbook: 2011
Managed Medicare and Medicaid Factbook: 2011 provides convenient access to up-to-date enrollment data so you can easily evaluate market share, make plan-by-plan or state-by-state comparisons, identify opportunities and develop strategies. It includes current statistics on:*MA, Medicare managed care, Medicare Part D and managed Medicaid enrollment*Medicare eligibles by state, market penetration by state and by region*Enrollees by type of product including Part D, Special Needs Plans, HMO, local PPO, regional PPO, PFFS and others*Directories of MA, Medicaid plans and Part D plans with contact information*MA and Medicaid plans financial trends
The completely updated Managed Medicare and Medicaid Factbook: 2011 also includes new coverage of these hot topics:*Costs, premiums, rate cuts and profitability;*Star ratings, quality bonuses and ACO alliances;*State initiatives in Medicaid; and*Marketing regulations and bid strategies, along with other challenges such as meaningful differences, rate cuts, RADV audits, RACs and data reporting requirements.
You can have all of this information at your fingertips no need to contact 50 different Medicaid agencies, scour through the convoluted CMS website, or cut and paste to get data into a format that lets you compare apples to apples. Our experts have compiled the most relevant and timely facts for you and presented them in a way that provides one, easy-to-access resource of the managed Medicare and Medicaid data you need to develop sound strategies for 2012 and beyond.
Table of ContentsCh 1: MA Market Developments*MA Market Expansions*Mergers and Acquisitions*Private-Fee-for-Service Plans*Special Needs Plans*Alliances With ACOsCh 2: Strategies and Challenges for Marketing MA and Part D Plans*2011 Enrollment Season*Regulation and Enforcement of Marketing Rules*Product Development and Benefit Design*Marketing AlliancesCh 3: Bid Submissions, Evaluations and Denials*Meaningful Differences Among Products*Bid Strategies, Challenges and Results*Bid Denials and ViolationsCh 4: Medicare and Medicaid Plans Financial Performance*MA Financial Trends*MA Financial Results*Medicaid Plans Financial Results*Stock Performance*Leadership Changes at Medicare and Medicaid PlansCh 5: Costs and Premiums for MA and Part D*Payment Rate Cuts*Rising Premiums*Cost SavingsCh 6: MA Plan Audits*Data Validation*RADVCh 7: New MA Data Reporting Requirements*Regulatory Burdens*RACs*Encounter Data ReportingCh 8: MA Star Ratings and Other Quality Initiatives*Criteria and Measures for Quality Ratings*Quality Bonuses*Flagging Poor Performers*NCQA RankingsCh 9: Medicare Managed Care Enrollment Trends and Market Share DataCh 10: Medicare Part D Prescription Drug Data*Enrollment Data*Federal Retiree Drug Subsidy*Low-Income Subsidy*Directory of PDPs Sorted by Parent OrganizationCh 11: Regional Managed Medicare Marketplace DataCh 12: MA Plan Directory*MA, Cost, PACE and Demonstration PlansCh 13: Dir. of Federal and Regional Medicare RegulatorsCh 14: Managed Medicaid Business Strategies and Developments*Medicaid Plans Expansion*Contract Decisions*Mergers and Acquisitions*Payment Rate Changes*Legal ConflictsCh 15: Managed Medicaid Developments in States*State Initiatives*States With Implemented Medicaid 1115 Waiver ProgramsCh 16: Managed Medicaid Enrollment and Market Share Data*Managed Medicaid Enrollment Data*Managed Medicaid Market Share DataCh 17: Dir. of Medicaid PlansCh 18: Directories of State Medicaid Regulators
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60 Minutes – 60 Billion Dollar Fraud (October 25, 2009)
Airdate 10/25/09 U.S. taxpayers are being charged for an arm and a leg – prosthetics, that is, and thousands of them – as part of a huge Medicaid and Medicare billing scam that’s siphoning off an estimated billion a year. In South Florida, Medicare fraud has pushed aside cocaine as the major criminal enterprise. The problem is so serious that U.S. Attorney General Eric Holder has organized a federal strike force. Steve Kroft reports.
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New-TOPS 50135R – Centers for Medicare and Medicaid Services Forms, 8-1/2 x 11, 250 Forms – TOP50135R
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning. Top sensor bar for microfiche duplication, as required in some states. OCR red ink for scanning. Form Size (W x H): 8 1/2 in x 11 in; Number of Columns: N/A; Forms Per Page: 1; Number of Entry Lines: N/A. Claim Form; Claim Forms; CMS; CMS-1500; Continuous Form; HCFA Claim Form; Health Care Claim Forms; Human Resources; Insurance Forms; Personnel; Personnel Forms; TOPS; Paperwork; Records; Documents; Pre-Printed; Record-Keeping
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