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Posting Date: 05/23/2019
Performance Standards
Performance Standards If providers are credentialing as an IDTF, then the performance standards shall be reviewed thoroughly before submitting a Medicare application. Refer to the IDTF Performance Standards and Attachment 2 beginning on page [...]
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Posting Date: 10/24/2024
Notification of the 2025 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review
Notification of the 2025 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controversy for ALJ hearing requests filed on or [...]
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Posting Date: 04/08/2021
Fraud and Abuse
Medicare Part B 101 Manual Fraud and Abuse Fraud and Abuse Unified Program Integrity Contractors Defining Fraud and Abuse Fraud Abuse Bribes, Kickbacks and Rebates Penalties Waiving Deductible and Coinsurance What You Can Do As a [...]
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Posting Date: 11/07/2024
November is Lung Cancer Awareness Month
November is Lung Cancer Awareness Month Lung cancer is the leading cause of cancer death in the United States and worldwide. Although education, research and treatment options for lung cancer have dramatically improved in recent years, lung [...]
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Posting Date: 04/28/2015
Office of Inspector General
Section 3: Fraud and Abuse Office of Inspector General Table of Contents Office of Inspector General Compliance Programs Benefits of a Compliance Program Elements of A Compliance Program OIG Compliance Guidance Self-Discovery [...]
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Posting Date: 06/23/2021
When to Use the Provider Contact Center Versus Self-Service Tools
When to Use the Provider Contact Center Versus Self-Service Tools The CMS requires contractors to provide self-service and electronic communication technologies as efficient, cost effective means of disseminating Medicare provider information, [...]
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Posting Date: 11/19/2020
2020 Changes Driven by You – National Government Services Self-Service Tools
2020 Changes Driven by You – National Government Services Self-Service Tools We are committed to improving your experience while using our secure self-service tools which includes our NGSConnex portal, our NGSMedicare.com website and our IVR [...]
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Posting Date: 12/20/2024
Fraud and Abuse_Part A_B_FQHC_HHH
Fraud & Abuse Fraud & Abuse Medicare fraud can cost the United States government hundreds of millions of dollars each year and the dollars lost increase the strain on the Medicare Trust Fund. CMS works with other government contractors and law [...]
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Posting Date: 12/20/2024
What Is Fraud_Part A_B_FQHC_HHH
What Is Fraud? What Is Medicare Fraud? Medicare Fraud is intentionally submitting false information to a government contractor to receive money or a benefit by knowingly and willfully executing a scheme to defraud this health care benefit [...]
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Posting Date: 12/20/2024
What Is Abuse_Part A_B_FQHC_HHH
What Is Abuse? What Is Abuse? Abuse describes incidents or practices that are: not medically necessary as defined by Medicare guidelines; or inconsistent with accepted sound medical, business or fiscal practices. Abuse occurs when individuals [...]
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Posting Date: 10/16/2023
Tips for Documenting Homebound Status
Tips for Documenting Homebound Status Comprehensive and accurate documentation is crucial to providing safe and effective care to Medicare beneficiaries. National Government Services' medical review team reviews this documentation while making [...]
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Posting Date: 03/22/2023
Hierarchy of Medicare Regulations
Hierarchy of Medicare Regulations Have you wondered how Medicare determines what is covered? Below you will find the hierarchy of how Medicare regulations are created. Social Security Act Title XVIII of the Social Security Act is [...]
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Posting Date: 10/19/2023
MLN Connects® Newsletter: October 19, 2023
MLN Connects® Newsletter: October 19, 2023 News 2024 Medicare Parts A & B Premiums and Deductibles Help CMS Improve Provider Resources — Respond by November 9 CMS Health Information Handler Helps You Submit [...]
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Posting Date: 10/26/2023
Part B Top Claim Errors Are Updated
Part B Top Claim Errors Are Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to avoid claim processing delays. We’ve listed the error reason code, a [...]
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Posting Date: 10/26/2023
Coming Soon ‒ The CY 2024 Medicare Physician Fee Schedule
Coming Soon - The CY 2024 Medicare Physician Fee Schedule The CY 2024 MPFS will soon be available on the Fee Schedule Lookup tool located on NGSMedicare.com, after the CY 2024 physician fee schedule regulation is put on display. Once the Fee [...]
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Posting Date: 10/10/2022
The Great American Smokeout is Coming!
The Great American Smokeout is Coming! As a health care professional who provides care to patients with Medicare, you can help protect the health of your patients by encouraging them to take advantage of Medicare-covered preventive services, [...]
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Posting Date: 04/06/2022
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022)
Tips to Find Local Coverage Determinations and Billing and Coding Instructions (REVISED 4/6/2022) We often receive suggestions through our website surveys to make it easier to find LCDs and the associated Billing and Coding articles. All [...]
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Posting Date: 02/22/2023
New Local Coverage Determination for Sacroiliac Joint Injections and Procedures
New Local Coverage Determination for Sacroiliac Joint Injections and Procedures National Government Services, as your MAC, is bringing to your attention a newly created LCD policy change that will effect providers who render and bill for [...]
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Posting Date: 02/10/2022
National Government Services Proposed LCDs for Comment
National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 2/10/2022 through 3/26/2022. These [...]
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Posting Date: 04/01/2021
Revised Coverage Policies for Facet Joint Interventions for Pain Management
Revised Coverage Policies for Facet Joint Interventions for Pain Management FUTURE Local Coverage Determination (LCD) Facet Joint Interventions for Pain Management (L35936) Billing and Coding: Facet Joint Interventions for Pain Management [...]
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