what will help you.
Health care providers need a partner that can help them truly understand their nuanced challenges, while providing them with a broader view of potential strategies to thrive.
Federal Law
Title XVIII of the Social Security Act (Medicare Statute)
Title XIX of the Social Security Act (Medicaid Statute)
Code of Federal Regulations (Title 42 contains rules governing Medicare, Medicare Advantage, Part D, and Medicaid)
Federal Register (find CMS proposed and final rules by date of publication)
Regulations.gov (search for proposed and final rules, locate public comments, determine rule status)
CMS Sub-Regulatory Guidance
Medicare Coverage Database (find National and Local Coverage Determinations)
Medicare Internet-Only Manuals (e.g., Claims Processing Manual, Benefit Policy Manual, State Operations Manual/Appendices)
Medicare Paper-Based Manuals (e.g., Provider Reimbursement Manuals, Parts 1 and 2, governing cost reporting)
Medicare Transmittals (find transmittals and change requests from CY 2000 to present implementing changes to Medicare manual provisions)
CMS Frequently Asked Questions Homepage (submit questions and see CMS responses to FAQs)
Medicare Administrative Decisions
(find administrative law opinions regarding cost reporting and other complex reimbursement issues challenged by providers)
CMS Provider Reimbursement Review Board (PRRB) Decisions Homepage
HHS Departmental Appeals Board and Administrative Law Judge (ALJ) Decisions Homepage
CMS Provider- and Supplier-Specific Homepages
(find important links to provider- and supplier-specific information regarding proposed and final payment rules, manuals, and enrollment information)
Other Helpful CMS Resources
CMS Forms Homepage (find all CMS forms, including enrollment and ABN forms)
Medicare Administrative Contractor Jurisdiction Homepage (find contractor information for each state for Parts A and B, DME, and Home Health and Hospice)