The Centers for Medicare & Medicaid Services has finalized the OASIS‑E2 Guidance Manual, effective April 1, 2026, introducing data set updates and clarifying that AI tools may assist but not complete ...

CMS recently issued a Medicare Learning Network (MLN) Matters article in connection with Change Request 11042 released on April 12, 2019 (the Change Request), which revises the Medicare Claims ...

As part of a broader effort to modernize the Medicare program through IT and innovation, the Centers for Medicare and Medicaid Services today announced changes to the way contractors decide which ...

CMS revised a chapter in the Medicare Program Integrity Manual, which details policies and procedures for Medicare Administrative Contractors and provides guidance for stakeholder engagement. 1. The ...

Although the Two Midnight Rule became effective on October 1, 2013, CMS had not updated manual guidance to incorporate the Two Midnight Rule until recently. As previously reported here, CMS updated ...

The Centers for Medicare & Medicaid Services (CMS) has proposed moving prior authorizations for prescription drugs to an electronic format to speed up approvals and improve administrative efficiency.

On December 27, 2016 CMS released its Final Manual for Reconciliation of the Cost-Sharing Reduction (CSR) Component of Advance Payments for Benefit Year 2016. Each month qualified health plan (QHP) ...

Federal regulators sent nursing home operators and their MDS personnel scurrying for favorite reading spots Monday after they released finalized item sets and 450 pages of heavily updated draft ...

The Centers for Medicare & Medicaid Services recently announced that it has posted both the MDS 3.0 QM User’s Manual V13.0 and Quality Measure Reporting Module Table V1.8. The user’s manual contains ...

Understanding the process of filing Medicare claims is essential for beneficiaries to ensure timely reimbursement for covered services and supplies. This article provides an overview of the Medicare ...