Names being circulated include FDA Commissioner Scott Gottlieb, Veterans Affairs Secretary David Shulkin and CMS Administrator Seema Verma.
By most accounts, the leading candidate is Seema Verma. Some of her actions at the CMS have alarmed the healthcare industry, including the decision to eliminate and scale back some mandatory bundled payment programs and her plan to seek a “new direction” for the CMS innovation center.
via With Price out at HHS, talk turns to replacement candidates
The most interesting exchange is at 44:00 in…
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.
CMS should focus its billing audits less on verifying medical necessity and more on rooting out blatant fraud, the agency’s likely next secretary said Tuesday. Rep. Tom Price, R-Ga.
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