Medicare & Medicaid

Medicare Appeals – Limiting the Scope of Review on Redeterminations and Reconsiderations of Certain Claims

CMS recently provided direction to A/B MACs and QICs regarding the scope of appellate review for redetermination (1st Level) and reconsideration (2nd Level) appeals of certain claims. Historically, MACs and QICs had discretion while conducting …..

2024-12-04T13:26:32-06:00August 1st, 2015|Categories: Health Law, Medicare & Medicaid|Tags: |

The Affordable Care Act and Closing the Prescription Benefit Coverage Gap

(“Doughnut Hole”) Medicare Part D Coverage Gap Under the Medicare Part D Prescription Drug Benefit, many Medicare beneficiaries have annually encountered a large gap in their prescription drug coverage that is commonly referred to as …..

2024-12-04T13:30:23-06:00October 8th, 2013|Categories: Health Law, Medicare & Medicaid Enrollment, Provider Operations|Tags: |
Go to Top