tci Medicare Compliance & Reimbursement - 2012 Issue 14
Industry Notes: 1.2 Million People To Come Under Medicare Services
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Article Overview
This industry note brings together a set of federal health policy and administrative updates from HHS, CMS, the OIG, and related programs. It is relevant to Medicare, Medicaid, and provider operations audiences who track accountable care initiatives, health insurance exchange implementation, home care oversight, NPI registry access, and denial-management resources tied to CERT activity. The article also highlights the broader Affordable Care Act context and references several reports, grants, and agency guidance items.
Why This Topic Matters
The piece helps readers monitor changes and announcements that may affect program participation, state planning, oversight expectations, and day-to-day provider administration. It is useful for organizations that need a current overview of CMS and HHS activity without diving into a single technical coding topic.
Article Sections
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1.2 Million People To Come Under Medicare Services
Summarizes the launch of new accountable care activity and related Medicare shared-savings developments. Also notes the federal policy context and agency statements surrounding the initiative.
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Another Major Step Towards Affordable Care
Covers federal funding and guidance intended to support state preparation for health insurance exchanges. References the broader implementation framework and state-focused grant activity.
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OIG Wants CMS To Strengthen Medicaid Home Care Oversight
Discusses Medicaid home- and community-based services oversight, including federal review findings and agency recommendations. Places the discussion in the context of ACA-related home care programs and state waiver administration.
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CMS Offers NPI Search Tip
Provides a brief operational update about the national provider enumeration system and registry performance. The section focuses on access and search-use information for providers and administrators.
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Home Health & Hospice MAC Debuts New Resource To Help You Figure Out CERT Denials
Highlights a Medicare administrative contractor resource related to CERT denial review and appeal workflow. The section is aimed at providers managing claim review results and related online tools.
What You Will Learn
- How recent CMS and HHS announcements relate to Medicare and Medicaid program activity
- What federal guidance is being used to support state health insurance exchange planning
- Which oversight topics are being emphasized for Medicaid home- and community-based services
- What operational notice CMS provided about the National Provider Identifier registry
- What administrative resource is available for reviewing CERT-related denials and appeals
Who Should Read This
- Medicare providers
- Medicaid providers
- Health care compliance staff
- Revenue cycle and billing staff
- Hospital and health system administrators
- Home health and hospice organizations
- State health policy staff
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