The Medicare Compliance Blog

Gould & Lamb's team of Medicare Compliance blogging experts share the latest compliance industry news about Medicare compliance reporting.

Future Considerations for Controlled-Release Oxycodone

In an effort to bring the use of Oxycodone CR under more effective control, H.R. 1366 cited as the “Stop Oxy Abuse Act of 2013” was introduced “to direct the Commissioner of Food and Drugs to modify the approval of any drug containing controlled-release (CR) oxycodone hydrochloride, to limit such approval to use for the relief of severe-only instead of moderate-to-severe pain, and for other purposes”.

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Why You Need to Align Yourself with the Right Reporting Agent

Quite possibly the single largest incentive to comply with the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) was the verbiage, “An entity… shall be subject to a civil money penalty of $1,000 for each day of noncompliance for each individual…” The fear of an absolute penalty at the rate of $1,000 per claim per day is very persuasive. The SMART Act, signed into law in early January 2013, softened the language in the statute such that an entity may be subject to a penalty of up to $1,000 per claim per day.

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CMS Speaks at 9th Annual NAMSAP Conference

National Alliance of Workers Compensation Professionals On Thursday, April 25, 2013 Panelists John P Albert - Acting Director, Division of Medicare Secondary Payer Policy and Operations; Cynthia Gross - Health Insurance Specialist, Division of Medicare Secondary Payer Policy and Operations; Elizabeth V. Poole - Health Insurance Specialist, Division of Medicare Secondary Payer Policy and Operations; and Barbara Jean Wright - Senior Technical Advisor, MSP were welcomed by almost 200 members of the National Alliance of Medicare Set Aside Professionals at its annual conference in Baltimore, Maryland.

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Mandatory Insurer Reporting in 2013 – Changes Ahead?

Our industry is now two years into the mandated production (liability – one year) of MMSEA Section 111 Reporting. Although we don’t have crystal balls to see into the future, the matters identified below will likely shape changes to MMSEA Section 111 reporting in 2013.

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US House of Representatives Passes SMART Act of 2012

The Strengthening Medicare and Repaying Taxpayers Act - SMART The United States House of Representatives today passed the Saving Medicare and Repaying Taxpayers (SMART) Act as part of a broader legislative effort. The SMART Bill was attached to...

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