Where can I find regulatory guidance on the conditions of participation in the Medicare program?
42 CFR 482 contains the health and safety requirements that hospitals must meet to participate in the Medicare and Medicaid programs.
Who makes the rules for Medicare?
Maximus Federal Services makes its decisions based on Medicare law and coverage policies.
What is NQF in CMS?
The National Quality Forum (NQF) is a private non-profit organization that reviews measures for endorsement. This measure review process, which NQF refers to as the Consensus Development Process (CDP), builds consensus-based input from a wide array of stakeholders to determine a measure’s endorsement status.
Who is CEO of Medicare?
Centene Names Rich Fisher SVP And Medicare CEO.
What are CMS conditions of participation?
Medicare conditions of participation, or CoP, are federal regulations with which particular healthcare facilities must comply in order to participate – that is, receive funding from – the Medicare and Medicaid programs, the largest payors for healthcare in the U.S. CoP are published in the Code of Federal Regulations …
What are CMS conditions for coverage?
CMS develops Conditions of Participation (CoPs) and Conditions for Coverage (CfCs) that health care organizations must meet in order to begin and continue participating in the Medicare and Medicaid programs.
What law regulates Medicare?
the Social Security Act Amendments
On July 30, 1965, President Johnson signed the Medicare Law as part of the Social Security Act Amendments. This established both Medicare, the health insurance program for Americans over 65, and Medicaid, the health insurance program for low-income Americans.
What is a quality measure?
Quality measures are standards for measuring the performance of healthcare providers to care for patients and populations. Quality measures can identify important aspects of care like safety, effectiveness, timeliness, and fairness.
What are NQF measures?
NQF has a portfolio of endorsed performance measures that can be used to measure and quantify healthcare processes, outcomes, patient perceptions, and organizational structure and/or systems that are associated with the ability to provide high-quality care.