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*  Federal Register :: Privacy Act of 1974; System of Records
... proposes to modify a current DHS system of records titled, ``Department of Homeland Security/U.S. Citizenship and Immigration ... U. To an individual's current employer to the extent necessary to determine employment eligibility or to a prospective employer ... Fee payment information (e.g., credit card number, Pay.gov Payment Tracking Number); ... DHS has provided a report of this system of records to the Office of Management and Budget and to Congress. ...
  https://www.federalregister.gov/documents/2017/09/18/2017-19365/privacy-act-of-1974-system-of-records
*  340B Drug Pricing Program - Wikipedia
Medicaid Services solicited public comment on whether it should adjust Outpatient Prospective Payment System (OPPS) payments to ... MedPAC, Report to the Congress: Medicare Payment Policy (Washington, D.C.: 2007) p. 70. Ibid. p. 50 59 Fed. Reg. 47884 (Sep. 19 ... Eligibility for the 340B program is defined under federal law. Six categories of hospitals are eligible to participate in the ... Because the [Outpatient Prospective Payment System] payment rates for drugs furnished to hospital outpatients are the same for ...
  https://en.wikipedia.org/wiki/340B_Drug_Pricing_Program
*  Disproportionate share hospital - Wikipedia
... of inpatient care bed days attributable to units or wards generally payable under the Inpatient Prospective Payment System ... Through these efforts, Congress and the Clinton administration cut federal DSH payments by 5% and limited their further growth ... The value of the hospital's DSH "index" determines the hospital's eligibility for a DSH payment and the size of the payment. ... This law also capped the amount a state could spend on DSH payments, but it did little to slow recycling. Congress responded in ...
  https://en.wikipedia.org/wiki/Disproportionate_share_hospital
*  Home Health Agency (HHA) Center - Centers for Medicare & Medicaid Services
Medicare Home Health Prospective Payment System Case-Mix Methodology Refinements: Overview of the Home Health Groupings Model ... Report to Congress on the Medicare Home Health Study: An Investigation on Access to Care and Payment for Vulnerable Patient ... in payments to HHAs in CY 2019 and extends the rural add-on payment for CYs 2019 through 2022. ... Physician Certification of Patient Eligibility for the Medicare Home Health Benefit. * MLN Matters® SE1436: Certifying Patients ...
  https://www.cms.gov/center/provider-Type/home-Health-Agency-HHA-Center.html
*  McGuireWoods Consulting - Washington Healthcare Update
For more information on the Home Health Prospective Payment System, click here. ... This requires states to maintain eligibility through 2019. The agreement reached does not touch on the details of how Congress ... CMS is planning a slight pay cut for home health agencies in 2018, by reducing Medicare payments to the agencies by 0.4 percent ... it also proposes a redesign of the payment system in 2019. Comments are due Sept. 25, 2017. ...
  https://www.mwcllc.com/ideas/updates/articles/2017/9/washington-hc-update-sep-18-2017.aspx
*  U.S. GAO - Medicare: Payment Methods for Certain Cancer Hospitals Should Be Revised to Promote Efficiency
Unlike beneficiaries seen at teaching hospitals paid under Medicare's prospective payment systems (PPS) in 2012, nearly all ... In doing so, Congress should provide that all forgone outpatient payments be returned to the Trust Fund. HHS had no general ... Analysis of Plan Year 2015 Application, Enrollment, and Eligibility-Verification Process. GAO-18-169: Published: Dec 21, 2017. ... Similarly, Medicare outpatient payment adjustments to PCHs resulted in overall payments that were about 37 percent higher, on ...
  https://www.gao.gov/products/GAO-15-199
*  Text of H.R. 2669 (110th): College Cost Reduction and Access Act (Passed Congress version) - GovTrack.us
Passed Congress version). H.R. 2669 (110th): College Cost Reduction and Access Act ... an alternative payment system that provides payments to institutions in an accurate and timely manner, except that this ... Eligibility Determinations. The Secretary shall establish procedures for annually determining the borrower's eligibility for ... if the applicant is a current or prospective teacher applying for a grant to obtain a graduate degree- ...
  https://www.govtrack.us/congress/bills/110/hr2669/text
*  Community health centers in the United States - Wikipedia
... using the Medicaid prospective payment system. The aim of these payment changes was to prevent health centers from using ... In 1989, Congress created the Federally Qualified Health Center (FQHC) program, which established a preferential payment policy ... In the same time period, grants for the uninsured decreased from 51% to 21%. In 2008, Medicaid payments had grown to account ... The expansion of CHCs has instead been largely funded by the growth in Medicaid resulting from eligibility expansions, coverage ...
  https://en.wikipedia.org/wiki/Community_health_centers_in_the_United_States
*  ABA Health eSource
Payments for drugs under the Hospital Outpatient Department (HOPD) prospective payment system would again be reformed. For ... And multiple companies may now qualify for 180 day exclusivity if they file their applications on the first day of eligibility ... Since the mid-1990s, however, Congress has been pushing for a more private sector oriented approach to providing Medicare ... and a separate report on the appropriateness of current payments under the inpatient prospective payment system (PPS). ...
  https://www.americanbar.org/content/newsletter/publications/aba_health_esource_home/focus_2_htm_focus_2.html
*  H.R.5926 - 114th Congress (2015-2016): Departments of Labor, Health and Human Services, and Education, and Related Agencies...
114th Congress (2015-2016): Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations ... Social Security system and the social security system of Mexico. (A totalization agreement coordinates the payment of Social ... provide information to prospective enrollees about insurance options and federal assistance, and examine enrollees' eligibility ... Payments for Foster Care and Permanency. Provides appropriations to the Administration for Community Living for Aging and ...
  https://www.congress.gov/bill/114th-congress/house-bill/5926?q=%7B%22search%22%3A%5B%22ebola%22%5D%7D
*  Current & Emerging Payment Models | AHA
... to payment based on the value of those services (value-based care and alternative payment models). ... Health care is currently in the middle of a transition from a system of payment based on the volume of services provided (fee- ... siloed payment systems, such as Medicare's inpatient and outpatient prospective payment systems. ... nearly a third of Medicare payments were attributed to alternative payment models. Thus, for now, hospitals and health systems ...
  https://www.aha.org/advocacy/current-and-emerging-payment-models?field_type_target_id_2=All&page=4
*  Federally Qualified Health Centers FAQ
Health centers have the Prospective Payment System (PPS) compensation rate, which is different from the Medicaid payments ... Due to Medicare eligibility, this group does have more "options" for care, but having an interdisciplinary "one stop shop" for ... In 2009, the U.S. Congress determined that federally supported health centers (FQHCs and "Look Alikes") may contract with ... Prospective Payment System reimbursement for services to Medicaid patientsi *Cost-based reimbursement for services to Medicare ...
  http://www.ada.org/en/public-programs/action-for-dental-health/access-to-care/federally-qualified-health-centers-faq
*  VAMP JAN10 by NMP Media Corp. - issuu
This was in April of payment default they would 2008 at the height of the make the payments for the mortgage industry crash ... recovery management system enabling mortgage originators to provide ongoing mortgage-qualifying services to prospective ... Congress closed that gap in the lender-provided consumer notices in 2003 with the provisions of FACTA that started requiring ... Lenders seeking approval to originate underwrite or service an FHA loan must meet the eligibility criteria for a supervised or ...
  https://issuu.com/nmpmag/docs/vamp_jan10
*  Toa Alta Comprehensive Urban/Rural Advanced Health Services, Inc.; Río Grande Community Health Center, Inc., Plaintiffs, v....
... court had already enjoined the Secretary to set in place a PPS reimbursement payment system and commence making payments to ... In this regard, Congress has anchored the scheme by which wraparound payments are to be calculated to the amount of visits made ... State to FQHCs are assessed through statutorily-set calculations established by Medicaid's Prospective Payment System ("PPS"). ... Fourth, the GHIP covers individuals, such as Puerto Rico Police officers, who do not meet eligibility criteria under Medicaid ...
  http://caselaw.findlaw.com/us-1st-circuit/1609208.html
*  Federal Register :: TRICARE; Outpatient Hospital Prospective Payment System (OPPS)
This interim final rule implements a prospective payment system for hospital outpatient services similar to that furnished to ... be temporary payments to ease the provider's transition from a prior cost-based payment system to a prospective payments system ... Congress also-in section 707 of NDAA-02-changed the statutory authorization (in 10 U.S.C. 1079(j)(2)) that TRICARE payment ... and/or cost-sharing/copayment amounts will be subtracted from the wage adjusted APC payment rate based on the eligibility ...
  https://www.federalregister.gov/documents/2007/08/14/E7-15924/tricare-outpatient-hospital-prospective-payment-system-opps
*  Medicare (United States) - Wikipedia
Medicare uses prospective payment systems. In a prospective payment system, the health care institution receives a set amount ... eligibility for and payment of Extra Help/Low Income Subsidy payments related to Part D Medicare, and collecting some premium ... In 2002, payment rates were cut by 4.8%. In 2003, payment rates were scheduled to be reduced by 4.4%. However, Congress boosted ... 113th Congress), a bill that would have replaced the (SGR) formula with new systems for establishing those payment rates. ...
  https://en.wikipedia.org/wiki/Medicare_(United_States)
*  Social Security (United States) - Wikipedia
Despite this, no serious challenges regarding the system's constitutionality are now being litigated, and Congress's spending ... In each year since 1982, OASDI tax receipts, interest payments and other income have exceeded benefit payments and other ... The eligibility formula requires a certain number of credits (based on earnings) to have been earned overall, and a certain ... A sole proprietor and officers of a corporation and managers of an LLC can be held personally liable for non-payment of the ...
  https://en.wikipedia.org/wiki/Social_Security_(United_States)
*  ANA Advises Federal Agencies
Prospective Payment System (PPS), which updated and revised the case-mix adjusted bundled prospective payment system for renal ... including the Merit-Based Incentive Payment System, Alternative Payment Models and Incentive Payments), dated November 16, 2015 ... Home >Policy & Advocacy >Congress and Federal Agencies >Agencies & Regulations >ANA Advises ANA Advises Federal Agencies. ^ m d ... eligibility and enrollment; exemptions and appeals; and other related topics. ANA's letter to CMS expressed concerns regarding ...
  http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Federal/AGENCIES/ANA-Advises-Federal-Agencies
*  HSC Research Brief No. 21
Medicare Payment Advisory Committee, Report to the Congress: Medicare and the Health Care Delivery System, Chapter Six, ... federal legislation required FQHCs to move to a prospective payment system (PPS). The PPS is based on health centers' previous ... Under the law, Medicaid eligibility in 2014 will expand to include all people with incomes up to 138 percent of federal poverty ... In many cases, they increased the proportion of insured patients, adapted to Medicaid managed care, collected payments due from ...
  http://www.hschange.org/CONTENT/1257/?topic=topic11
*  CAAR Report
A. 'Review of Compliance with the Consolidated Billing Provision Under the Prospective Payment System,' (A-01-99-00531, March ... system edit allows these DME payments to be made. We also found some payments for Part A and Part B services where the ... eligibility criteria, especially age. While age alone is not a contraindication to transplantation, conflicting data exists ... http://www.access.gpo.gov/congress/house/house19ch106.html. Scroll to 'Hrg. No. 106-23' at the bottom of the page for full text ...
  https://www.ssc.wisc.edu/cdha/caar/caar27-march-30-2000.htm
*  Home Health Care
Medicare officials stated that under a proposed new payments system this would change. Under the 'episode of care' system home ... You are responsible for the costs that Medicare does not cover and a 20% co-insurance payment on Durable Medical Equipment, if ... The sharp decline in spending has been attributed to the changes that Congress adapted in Medicare spending under the Balanced ... Medicaid, the state-federal government program for the poor, does cover longer term home health services, but eligibility and ...
  http://therubins.com/medicare/homehealt.htm
*  This Week @ ACFAS
... changes in the risk adjustment program for the next two years and 2018 payment parameters. Plan benefits, eligibility ... The rule is subject to the Congressional Review Act and could be disapproved by a joint resolution of the new Congress.. From ... The review included prospective studies that performed ultrasound imaging of Achilles or patellar tendon structure in ... Physicians participating in advanced APMs are eligible to earn a lump sum bonus of up to five percent on Medicare payments. ...
  https://www.acfas.org/ThisWeek/ThisWeek_12282016.html
*  Washington Healthcare Update: June 23, 2014 - Food, Drugs, Healthcare, Life Sciences - United States
Ways and Means hearing on MedPAC June 2014 Report to Congress. Administration releases data on premiums and competition in ACA ... CMS issued a final rule with comment period to implement methodology and payment rates for a prospective payment system (PPS) ... 1. Congress. House. Medical Providers Expanding Use of Narrower Networks. On June 12, House Energy and Commerce Committee's ... California Expands Eligibility for "Covered California" Board. On June 18, the California Assembly passed a bill to open up the ...
  http://www.mondaq.com/unitedstates/x/324702/Healthcare/Washington+Healthcare+Update
*  Medicare | Encyclopedia.com
... many of its supporters believed that insuring persons age sixty-five and over was a precursor to a national system of health ... The hospital payment system for Medicare now pays a flat rate to a hospital, based on the patient's diagnosis. While hospitals ... Physician payment changes in Medicare sought to rebalance the level of payments between primary-care physicians and specialists ... Under DRGs, hospitals are paid on a prospective basis to encourage efficiency. The RBRVS makes it possible to redress payment ...
  https://www.encyclopedia.com/medicine/divisions-diagnostics-and-procedures/medicine/medicare
*  Omnibus Territories Act of 2013 - Wikipedia
... that would constitute a severe personal injury or a personal injury and adjudicate claims and determine payment eligibility. ... Library of Congress - Thomas S. 1237 beta.congress.gov S. 1237 GovTrack.us S. 1237 OpenCongress.org S. 1237 WashingtonWatch.com ... such payments to be made after payments have been made to surviving Guam residents). The bill would direct the Foreign Claims ... Croix, U.S. Virgin Islands, as a unit of the National Park System in order to preserve, protect, and interpret a Caribbean ...
  https://en.wikipedia.org/wiki/Omnibus_Territories_Act_of_2013