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  2. National coverage determination - Wikipedia

    en.wikipedia.org/wiki/National_coverage...

    When new LCDs are developed, a 731 Advisory Group reviews LCD topic submissions to determine which topics are forwarded to the CMS Coverage and Analysis Group (CAG). [2] To promote consistency across LCDs, CMS requires Medicare contractors to: [2] Consult with other contractors prior to developing a new policy; Adopt or adapt existing LCDs when ...

  3. Diagnosis-related group - Wikipedia

    en.wikipedia.org/wiki/Diagnosis-related_group

    The history, design, and classification rules of the DRG system, as well as its application to patient discharge data and updating procedures, are presented in the CMS DRG Definitions Manual (Also known as the Medicare DRG Definitions Manual and the Grouper Manual). A new version generally appears every October. The 20.0 version appeared in 2002.

  4. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]

  5. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    In 2006 the Tax Relief and Health Care Act (TRHCA) included a provision for a 1.5% incentive payment to eligible providers who successfully submitted quality data to CMS. This provision included a cap on payments. The 2007 Medicare, Medicaid, and SCHIP Extension Act extended the program through 2008 and 2009. It also removed the TRHCA payment cap.

  6. Hospice, Inc. - The Huffington Post

    projects.huffingtonpost.com/hospice-inc

    Under Medicare guidelines, hospice patients require a terminal diagnosis or markers of a life-threatening condition — such as severe weight loss or loss of mobility — indicating the person will likely die within six months or sooner. Maples did not have a terminal illness. Her diagnosis was “debility, unspecified,” according to her records.

  7. Center for Medicare and Medicaid Innovation - Wikipedia

    en.wikipedia.org/wiki/Center_for_Medicare_and...

    The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform

  8. National Quality Cancer Care Demonstration Project Act of 2009

    en.wikipedia.org/wiki/National_Quality_Cancer...

    H.R. 3675 calls for national reporting, via the Medicare payment system, of key metrics of evidence based care, refinement of those metrics, and development of a new Medicare performance-based reimbursement system that is patient-centric and quality driven, while aligning better with parameters of cost control.

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