Claim Denials

Latest Headlines

Latest Headlines

New fraud prevention rule gives CMS greater discretion

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule focusing on new safeguards to reduce Medicare fraud. The new rule gives CMS the "ability to deny or revoke the enrollment of entities and individuals that pose a program integrity risk to Medicare."

CMS expands contractors' claims denial authority

The Centers for Medicare & Medicaid Services broadened contractors' discretionary authority to deny claims related to other denials stemming from prepayment or post-payment review, JDSupra Business Advisor reported.

HHS shrinks consumer right to appeal coverage denial

New rules issued by the Department of Health & Human Services (HHS) downgrade consumers' rights to appeal insurers' denials of coverage, providing them less time to prepare appeals, less