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Posting Date: 03/11/2020
Hospice Claims Adjustments
Hospice Claims Adjustments National Government Services has received reports of two issues that are currently affecting payments of some hospice claims that have been adjusted. Hospice End of Life SIA Payment Hospice claims are being [...]
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Posting Date: 05/11/2020
Home Health Plans of Care: NPs, CNSs and PAs Allowed to Certify
Home Health Plans of Care: Nurse Practitioners, Clinical Nurse Specialists and Physician Assistants Allowed to Certify Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections [...]
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Posting Date: 03/12/2020
Hospice Agencies and COVID-19
Hospice Agencies and COVID-19 CMS has issued a memorandum responding to questions related to hospice agencies, the COVID-19 (Corona Virus) outbreak, and minimizing transmission to other individuals. It is suggested that [...]
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Posting Date: 07/24/2020
HHS Secretary Alex M. Azar III Renewed the COVID-19 Public Health Emergency Declaration on 7/23/2020
HHS Secretary Alex M. Azar III Renewed the COVID-19 Public Health Emergency Declaration on 7/23/2020 As a result of the continued consequences of Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public [...]
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Posting Date: 11/30/2020
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and during [...]
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Posting Date: 08/27/2020
Flu and Pneumonia Shots: Extra Push This Fall and Spring
Flu and Pneumonia Shots: Extra Push This Fall and Spring National Government Services supports the CMS and NIAM recent announcements to make strong recommendations for Medicare patients to get their flu/pneumonia shots and refer Medicare [...]
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Posting Date: 08/26/2020
Flu Season 2020-2021 Has Arrived
Flu Season 2020-2021 Has Arrived The 2020-2021 flu season began on 8/1/2020. The Medicare flu billing codes and fees along with the brand name and manufacturer are located on the CMS Seasonal Influenza Vaccines Pricing web page. Please note: [...]
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Posting Date: 11/30/2020
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement
Don’t Forget the CMS-588 Electronic Funds Transfer Authorization Agreement The CMS-588 Electronic Funds Transfer Authorization Agreement is to be submitted for billing providers upon initial enrollment, change in bank information and during [...]
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Posting Date: 08/03/2020
Extension for Inpatient Prospective Payment System (IPPS) Wage Index Occupational Mix Survey Submission
Extension for Inpatient Prospective Payment System (IPPS) Wage Index Occupational Mix Survey Submission CMS collects data every three years on the occupational mix of employees for each short-term, acute care hospital participating in the [...]
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Posting Date: 06/30/2020
Exceptions to the RHC Productivity Standards for RHCs as a Result of the COVID-19 Public Health Emergency
Exceptions to the RHC Productivity Standards for RHCs as a Result of the COVID-19 Public Health Emergency Productivity standards are used to help determine the average cost per patient for Medicare reimbursement in RHCs. Physicians, nurse [...]
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Posting Date: 11/17/2020
Direct Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, for Participating Medicare Advantage Organizations (MAOs)
Direct Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, for Participating Medicare Advantage Organizations (MAOs) This Change Request (CR) details the requirements of [...]
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Posting Date: 08/17/2020
Cyber Alert: Malicious Cyber Actor Spoofing COVID-19 Loan Relief Webpage via Phishing Emails
Cyber Alert: Malicious Cyber Actor Spoofing COVID-19 Loan Relief Webpage via Phishing Emails National Government Services wants to share the following alert from the HHS Office of Civil Rights Office that was issued Friday, 8/14/2020. Please [...]
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Posting Date: 06/30/2020
Cost Report Submission Due Dates
Cost Report Submission Due Dates Due to updated instructions received from the CMS relative to the COVID-19 public health emergency and in accordance with 42CFR§413.24(f)(2)(ii), the due date for submission of Medicare cost reports has again [...]
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Posting Date: 06/19/2020
July 2020 Release "Dark Days" for the Common Working File Hosts
July 2020 Release "Dark Days" for the Common Working File Hosts For the upcoming July 2020 Release: For Production, CWF will be observing dark days starting Friday, 7/3/2020 through Sunday, 7/5/2020 to accommodate the anticipated duration [...]
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Posting Date: 12/07/2020
January 2021 Release "Dark Days" for the Common Working File Hosts
January 2021 Release "Dark Days" for the Common Working File Hosts For the upcoming January 2021 Release: For Production, Common Working File (CWF) will be observing the Gray Day on Wednesday, 12/30/2020, and Dark Days starting Thursday, [...]
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Posting Date: 12/08/2020
January 2021 EDI Front End Quarterly Release: New and Modified Edits
January 2021 EDI Front End Quarterly Release: New and Modified Edits Part A Edit Changes: Edit Reference Number Change Reason for change Trading Partner Impact/Results X223. 433.2400.DTP03.040 Revised 277C [...]
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Posting Date: 01/02/2020
January 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes
January 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Changes Therapy Attachment (44) has been removed from the Claims Correction Menu (MAP1704). (Correction) Entry added for new Bone Density HCPCS codes 0554T-0558T [...]
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Posting Date: 08/26/2020
National Government Services Part B Medical Review Newsletter September 2020
National Government Services Part B Medical Review Newsletter September 2020 National Government Services MR Department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find this newsletter [...]
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Posting Date: 12/11/2020
National Government Services Part B Medical Review Newsletter December 2020
National Government Services Part B Medical Review Newsletter December 2020 The National Government Services Medical Review department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find [...]
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Posting Date: 12/10/2020
Reminder: NGS Appeals Requesting Reimbursement Change for HCPCS Code G0463
Reminder: National Government Services Appeals Requesting Reimbursement Change for HCPCS Code G0463 Appeals activities conducted by National Government Services are governed by CMS. Providers and beneficiaries have the right to appeal claim [...]
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Posting Date: 06/12/2020
July 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Change
July 2020 Fiscal Intermediary Standard System Direct Data Entry Screen Change The purpose of the New MAP171G is to display the OASIS information and make it viewable for home health providers. To access the New MAP171G from the FISS Inquiries [...]
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Posting Date: 11/06/2020
Invalid National Drug Code for the 2020-2021 Flu Season
Invalid National Drug Code for the 2020-2021 Flu Season National Government Services has noticed a large amount of claims being billed for the 2020-2021 flu season with the incorrect CPT codes for influenza flu vaccines. The NDCs change each [...]
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Posting Date: 11/09/2020
Internet Only Manual Update, Pub. 100-04, Chapter 11 - This CR Rescinds and Fully Replaces CR 11807
Internet Only Manual Update, Pub. 100-04, Chapter 11 - This CR Rescinds and Fully Replaces CR 11807 This Change Request (CR) makes updates to the manual language regarding submitting Notice of Termination/Revocation, Processing Professional [...]
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Posting Date: 03/04/2020
Incorrect Medicare Identification Numbers Submitted on Provider Enrollment Forms
Incorrect Medicare Identification Numbers Submitted on Provider Enrollment Forms Providers/suppliers enrolled in multiple business types (Part A, Part B and/or DME) should be cautious of what identifying numbers are submitted on Medicare [...]
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Posting Date: 06/25/2020
Incorrect Billing of HCPCS L8679 - Implantable Neurostimulator, Pulse Generator, Any Type
Incorrect Billing of HCPCS L8679 - Implantable Neurostimulator, Pulse Generator, Any Type An MLN Matters® Article SE20001 on Incorrect Billing of HCPCS L8679 - Implantable Neurostimulator, Pulse Generator, Any Type is available. Reminder [...]
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Posting Date: 07/27/2020
Implementation of Pre-Payment Editing for Psychiatric Inpatient Hospital Services
Implementation of Pre-Payment Editing for Psychiatric Inpatient Hospital Services Inpatient psychiatric hospitalization provides 24 hours of daily care in a structured, intensive and secure setting for patients who cannot be safely and/or [...]
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Posting Date: 04/13/2020
Immediate Infusion of $30 Billion into Health Care System
Immediate Infusion of $30 Billion into Health Care System Recognizing the importance of delivering funds in a fast and transparent manner, $30 billion is being distributed immediately through a program administered by the Department of Health [...]
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Posting Date: 06/26/2020
MLN Connects® Special Edition for Friday, June 26, 2020
MLN Connects® Special Edition for Friday, June 26, 2020 COVID-19: SNF Benefit Period Waiver, HHAs Proposed Rule, Ending Nursing Home Blanket Waiver HHAs: Proposed Payment and Policy Changes and Home Infusion Therapy Benefit for CY 2021 [...]
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Posting Date: 06/22/2020
MLN Connects® Special Edition for Friday, June 19, 2020
MLN Connects® Special Edition for Friday, June 19, 2020 Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients Today, the CMS has instructed Medicare Administrative Contractors and notified Medicare Advantage plans to [...]
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Posting Date: 08/03/2020
MLN Connects® Special Edition for Friday, July 31, 2020
MLN Connects® Special Edition for Friday, July 31, 2020 FY 2021 Medicare Payment Policies for IPFs, SNFs, and Hospices CMS Updates Medicare Payment Policies for IPFs, SNFs, and Hospices COVID-19: Coverage of Physician Telehealth Services [...]
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Posting Date: 07/20/2020
MLN Connects® Special Edition for Friday, July 17, 2020
MLN Connects® Special Edition for Friday, July 17, 2020 COVID-19: Nursing Home Testing, SNF Benefit Period Waiver MLN Matters Special Edition Article SE20011 Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the [...]
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Posting Date: 12/18/2020
MLN Connects® Special Edition for Friday, December 18, 2020
MLN Connects® Special Edition for Friday, December 18, 2020 COVID-19: Add-on Payment for New Treatments CMS issued an Interim Final Rule with Comment Period, which established the New COVID-19 Treatments Add-on Payment (NCTAP) under the [...]
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Posting Date: 08/28/2020
MLN Connects® Special Edition for Friday, August 28, 2020
MLN Connects® Special Edition for Friday, August 28, 2020 CMS Offers Comprehensive Support for Louisiana and Texas with Hurricane Laura On August 27, CMS announced efforts underway to support Louisiana and Texas in response to Hurricane [...]
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Posting Date: 08/05/2020
MACs Resume Medical Review on a Post-Payment Basis
MACs Resume Medical Review on a Post-Payment Basis To protect the Medicare Trust Fund against inappropriate payments, Medicare Administrative Contractors (MACs) are resuming fee-for-service medical review activities. Beginning August 17, the [...]
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Posting Date: 11/23/2020
LCD and Article Updates for December 2020
LCD and Article Updates for December 2020 New LCDs/Articles effective 12/1/2020 Implantable Continuous Glucose Monitors (I-CGM) (L38623/A58116) National Government Services considers Implantable Continuous Glucose Monitors medically [...]
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Posting Date: 10/23/2020
LCD and Article Updates for October/November 2020
LCD and Article Updates for October/November 2020 Revised LCD, Billing and Coding Articles October 2020 Botulinum Toxins(L33646) The following CMS IOM sections have been corrected: CMS IOM Publication 100-02, Medicare [...]
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Posting Date: 04/01/2020
LCD and Article Updates: March–April 2020
Local Coverage Determinations and Article Updates March/April 2020 The medical policies and related articles can be found in our Medical Policy Center. New LCDs/Articles effective April 1, 2020 Hypoglossal Nerve Stimulation for the Treatment [...]
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Posting Date: 04/27/2020
LCD and Article Revisions: May 2020
Local Coverage Determinations and Article Revisions May 2020 The medical policies and related articles can be found in our Medical Policy Center. Fluid Jet System in the Treatment of Benign Prostatic Hyperplasia (BPH) (L38367) The Notice [...]
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Posting Date: 07/23/2020
MLN Connects® Special Edition for Thursday, July 23, 2020
MLN Connects® Special Edition for Thursday, July 23, 2020 Trump Administration Announces New Resources to Protect Nursing Home Residents Against COVID-19 As part of the unprecedented efforts taken by the Trump Administration, President [...]
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Posting Date: 12/03/2020
MLN Connects® Special Edition for Thursday, December 3, 2020
MLN Connects® Special Edition for Thursday, December 3, 2020 COVID-19 Antibody Treatment and Enforcement Discretion Reminder COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing [...]
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Posting Date: 12/11/2020
MLN Connects® Special Edition for Thursday, December 10, 2020
MLN Connects® Special Edition for Thursday, December 10, 2020 CMS Proposes New Rules to Address Prior Authorization and Reduce Burden on Patients and Providers On December 10, under President Trump’s leadership, CMS issued a proposed rule [...]
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Posting Date: 07/07/2020
MLN Connects® Special Edition for Monday, July 6, 2020
MLN Connects® Special Edition for Monday, July 6, 2020 ESRD PPS CY 2021 Proposed Rule; COVID-19: New and Expanded Flexibilities for RHCs & FQHCs ESRD PPS CY 2021 Proposed Rule COVID-19: New and Expanded Flexibilities for RHCs [...]
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Posting Date: 12/28/2020
MLN Connects® Special Edition for Monday, December 28, 2020
MLN Connects® Special Edition for Monday, December 28, 2020 Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through March The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment [...]
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Posting Date: 12/15/2020
MLN Connects® Special Edition for Monday, December 14, 2020
MLN Connects® Special Edition for Monday, December 14, 2020 COVID-19 Vaccine Codes: Updated Effective Date for Pfizer-BioNTech On December 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for [...]
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Posting Date: 04/27/2020
MLN Connects® Special Edition for Monday, April 27, 2020
MLN Connects® Special Edition for Monday, April 27, 2020 CMS Reevaluates Accelerated Payment Program and Suspends Advance Payment Program On April 26, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating [...]
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Posting Date: 09/21/2020
MLN Connects® Special Edition for Friday, September 18, 2020
MLN Connects® Special Edition for Friday, September 18, 2020 New COVID-19 Nursing Home Visitation Guidance, Kidney Disease Care Model, & Radiation Oncology Payment Model CMS Announces Transformative New Model of Care for Medicare [...]
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Posting Date: 09/11/2020
MLN Connects® Special Edition for Friday, September 11, 2020
MLN Connects® Special Edition for Friday, September 11, 2020 Community Health Access and Rural Transformation Model The CMS Innovation Center announced the Community Health Access and Rural Transformation (CHART) Model. The approximately 57 [...]
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Posting Date: 10/16/2020
MLN Connects® Special Edition for Friday, October 16, 2020
MLN Connects® Special Edition for Friday, October 16, 2020 Enforcement Discretion Relating to Certain Pharmacy Billing The Centers for Medicare & Medicaid Services (“CMS”) appreciates its long-standing partnership with immunizers, [...]
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Posting Date: 05/08/2020
MLN Connects® Special Edition for Friday, May 8, 2020
MLN Connects® Special Edition for Friday, May 8, 2020 COVID-19: Nursing Home Reporting, Updated Telehealth Video, Pharmacies & Other Suppliers Can Enroll as Labs, IRF Flexibilities New Guidance Available on Requirements for [...]
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Posting Date: 05/18/2020
MLN Connects® Special Edition for Friday, May 15, 2020
MLN Connects® Special Edition for Friday, May 15, 2020 COVID-19: Deadlines, New Releases, and Important Calls COVID-19: Office Hours Call — May 21 COVID-19: Lessons from the Front Lines Call — May 22 Deadline Approaching: [...]
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Posting Date: 12/10/2020
MLN Connects® Special Edition for Wednesday, December 9, 2020
MLN Connects® Special Edition for Wednesday, December 9, 2020 In Case You Missed It: CMS Announces Guidance for Medicare Coverage of COVID-19 Antibody Treatment On December 9, CMS posted updates to FAQs and an infographic about coverage and [...]
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Posting Date: 12/02/2020
MLN Connects® Special Edition for Wednesday, December 2, 2020
MLN Connects® Special Edition for Wednesday, December 2, 2020 Trump Administration Finalizes Policies to Give Medicare Beneficiaries More Choices around Surgery Outpatient Prospective Payment System and Ambulatory Surgical Center final rule [...]
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Posting Date: 10/28/2020
MLN Connects® Special Edition for Tuesday, October 27, 2020
MLN Connects® Special Edition for Tuesday, October 27, 2020 New CMS Proposals Streamline Medicare Coverage, Payment, and Coding for Innovative New Technologies and Provide Beneficiaries with Diabetes Access to More Therapy Choices Durable [...]
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Posting Date: 11/11/2020
MLN Connects® Special Edition for Tuesday, November 10, 2020
MLN Connects® Special Edition for Tuesday, November 10, 2020 Coverage Available at No Cost to Beneficiaries Across Variety of Settings in Health Care System CMS announced that starting November 10, Medicare beneficiaries can receive coverage [...]
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Posting Date: 05/12/2020
MLN Connects® Special Edition for Tuesday, May 12, 2020
MLN Connects® Special Edition for Tuesday, May 12, 2020 COVID-19: Additional Waivers, Price Transparency, and CMS Letter to Nursing Homes CMS Releases Additional Waivers for Hospitals and Other Facilities Price Transparency: [...]
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Posting Date: 12/22/2020
MLN Connects® Special Edition for Tuesday, December 22, 2020
MLN Connects® Special Edition for Tuesday, December 22, 2020 COVID-19 Vaccine Codes: Updated Effective Date for Moderna On December 18, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Moderna [...]
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Posting Date: 12/02/2020
MLN Connects® Special Edition for Tuesday, December 1, 2020
MLN Connects® Special Edition for Tuesday, December 1, 2020 Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients On December 1, CMS released the annual Physician Fee [...]
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Posting Date: 08/05/2020
MLN Connects® Special Edition for Tuesday, August 4, 2020
MLN Connects® Special Edition for Tuesday, August 4, 2020 PFS, OPPS, and IRF: FY 2021 Payment Rules Trump Administration Proposes to Expand Telehealth Benefits Permanently for Medicare Beneficiaries Beyond the COVID-19 Public Health [...]
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Posting Date: 09/18/2020
MLN Connects® Special Edition for Thursday, September 17, 2020
MLN Connects® Special Edition for Thursday, September 17, 2020 Nursing Home COVID-19 Commission Findings, Oregon Wildfires, & Flu CMS Offers Comprehensive Support for Oregon due to Wildfires Protect Yourself & Your Patients from [...]
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Posting Date: 10/09/2020
MLN Connects® Special Edition for Thursday, October 8, 2020
MLN Connects® Special Edition for Thursday, October 8, 2020 CMS Announces New Repayment Terms for Medicare Loans Made to Providers During COVID-19 New recoupment terms allow providers and suppliers one additional year to start loan payments. [...]
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