Other Resources

Disclaimer: This page contains external links that are not the responsibility of, or under the control of, TriSpan Health Services, or the Centers for Medicare & Medicaid Services. TriSpan Health Services, acting as a contracted agent of the Centers for Medicare & Medicaid Services, does not endorse any commercial product or service.

Links for People with Medicare
(Links that are of special interest to people with Medicare are marked with an asterisk*)

Administration on Aging

Centers for Medicare & Medicaid Services

Department of Health and Human Services Agencies

healthfinder™

National Center for Policy Analysis

National Library of Medicine

Social Security Administration

TRICARE (formerly CHAMPUS)

Links for Medicare Providers

Administration on Aging

Centers for Medicare & Medicaid Services

Commerce Clearing House (CCH) Incorporated

Department of Health and Human Services Agencies

Federal Bureau of Investigation

General Accounting Office

Government Printing Office

Healthcare Financial Management Association

Health Care Compliance Manager

National Center for Policy Analysis

National Library of Medicine

Office of the Inspector General

Social Security Administration

Social Security Statute (Cornell University Law Library)

The Bureau of National Affairs

U.S. General Services Administration

U. S. Department of Justice

Washington Publishing Company

Administration on Aging

*Administration on Aging Home Page

http://www.aoa.gov/index.asp

The Administration on Aging is a new operating division of the Department of Health and Human Services.

*Administration on Aging

http://www.aoa.gov/press/press.asp

This page contains Administration on Aging press releases and other information.

*Administration on Aging Fact Sheets

http://www.aoa.gov/press/fact/fact.asp

Fact sheets on a wide range of topics developed by the Administration on Aging.

Administration on Aging - Senior Medicare Patrols

http://www.aoa.dhhs.gov/smp/index.asp

Administration on Aging Statistical Profiles

http://www.aoa.gov/prof/Statistics/statistics.asp

The Administration on Aging provides statistical information on older persons.

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Centers for Medicare & Medicaid Services

Ambulatory Surgical Centers (ASC)

http://www.cms.hhs.gov/center/asc.asp

Information on Enrollment/Participation, Payment Rates, and Regulations

Centers for Medicare & Medicaid Services Homepage

http://www.cms.hhs.gov

Clinical Laboratory Information

http://www.cms.hhs.gov/center/clinical.asp

Billing/Payment, Regulations, Educational Publications, Demonstrations, Coding, National Coverage Determinations, CMS Manual References

*Beneficiary Frequently Asked Questions

http://medicare.custhelp.com/cgi-bin/medicare.cfg/php/enduser/std_alp.php

Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS)

http://www.cms.hhs.gov/center/dme.asp

Billing Instructions, Coding, Payment, and Medical Review information

Emergency Medical Treatment & Labor Act (EMTALA)

http://www.cms.hhs.gov/EMTALA/

Policy, Regulations, Manuals, and Frequently Asked Questions

End-Stage Renal Disease (ESRD) Information Resource

http://www.cms.hhs.gov/ESRDGeneralInformation/

Regulations, Coverage, Billing, Demonstrations, CROWN, Forms, Network Organizations, Public Use Files, Publications, and Dialysis Facility Compare

Federally Qualified Health Centers (FQHC)

http://www.cms.hhs.gov/center/fqhc.asp

Regulations, HIPAA, Enrollment, Frequently Asked Questions, Forms, Manuals, and Publications

Guided Pathways to Medicare Resources for Medicare Fee-for-Service Health Care Professionals

http://www.cms.hhs.gov/apps/training/guidedpathways/index.html

Guided Pathways has been developed as an educational tool for fee-for-service (FFS) health care staff who are relatively unfamiliar with the Medicare Program, as well as for those professionals looking for easy access to the many resources on the CMS website. Using a “road trip” motif, the pathways lead users through nine broad sections of information covering the Medicare Program, with links to further pertinent information. The pathways also provide links to other government resources pertaining to Medicare FFS items.

*Helpful Contacts

http://www.medicare.gov/Contacts/Home.asp

*Home Health Information Resource for Medicare

http://www.cms.hhs.gov/center/hha.asp

Regulations, Coding, Billing, Outcome and Assessment Information Set (OASIS) and Outcome-Based Quality Improvement (OBQI)

CMS HIPAA Website

http://www.cms.hhs.gov/HIPAAGenInfo/

The Health Insurance Portability and Accountability Act includes a provision establishing the "Medicare Integrity Program."

Hospice

http://www.cms.hhs.gov/center/hospice.asp

Certification, Educational Articles, Frequently Asked Questions, and Research and Statistics information

Information for Health Care Professionals on the Medicare-Approved Drug Discount Cards and Transitional Assistance Program

http://www.cms.hhs.gov/MLNProducts/23_DrugCoverage.asp

This page includes educational materials for Medicare physicians, other health care professionals, pharmacists, other pharmacy professionals and pharmacies geared toward explaining the fundamental elements of the Medicare-Approved Drug Discount Cards and Transitional Assistance Program.

Information and Education Resources for Medicare Providers, Suppliers, and Physicians

http://www.cms.hhs.gov/MLNGenInfo/

A Medicare Learning Network article to meet the Medicare business needs of physicians and other providers has been developed by the Center for Medicare and Medicaid Services.

Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS)

http://www.cms.hhs.gov/InpatientPsychFacilPPS/

Useful information related to the development of a PPS for Medicare inpatient psychiatric services, including Background and Coding information, and the proposed Regulation and Assessment Tool

Mammography Services

http://www.cms.hhs.gov/Mammography/01_overview.asp

Coding, Policies/ Regulations, and helpful Resources

*Medicare & Other Health Benefits: Your Guide to Who Pays First

http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf

*Medicare & You 2007 (Medicare Handbook)

http://www.medicare.gov/Publications/Pubs/pdf/10050.pdf

*Medicare Basics, A Guide for Caregivers

http://www.medicare.gov/Publications/Pubs/pdf/11034.pdf

Medicare - Civil Monetary Penalty Statue References

http://cms.hhs.gov/MCAIDFraudAbuseGenInfo/

Medicare - CMS Manuals and Transmittals

http://www.cms.hhs.gov/manuals/01_overview.asp

http://www.cms.hhs.gov/transmittals/01_overview.asp

*Medicare - Consumer Fraud Pamphlet

http://www.medicare.gov/Publications/Pubs/pdf/fraud.pdf

Medicare Contractor Provider Satisfaction Survey (MCPSS)

http://www.cms.hhs.gov/mcpss

This site provides helpful information regarding the MCPSS including an overview and contact information.

Medicare Contractor Provider Satisfaction Survey (MCPSS) Home Study Page

https://www.mcpsstudy.org

This site provides information about MCPSS to the physician and provider community, provider organizations and associations and particularly to our Medicare FFS Contractors, including Medicare Administrative Contractors (MACs).

Medicare Coverage Database

http://www.cms.hhs.gov/mcd/search.asp?

*Medicare Fraud Reward Program

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=64

Department of Health and Human Services announces a program to reward reports of Medicare fraud.

Medicare Physician Fee Schedule Lookup

http://www.cms.hhs.gov/apps/pfslookup/

View physician service information, geographic practice cost indices and payment policy.

Medicare Remit Easy Print (MREP) software

CMS presents the Medicare Remit Easy Print (MREP) software to view and print the Health Insurance Portability and Accountability Act (HIPAA) compliant 835 for professional providers and suppliers. This software, which is available for free to Medicare providers and suppliers, can be used to access and print remittance advice information, including special reports, from the HIPAA 835.

Medicare Prescription Drug Coverage Information for Providers

http://www.cms.hhs.gov/MedlearnProducts/23_drugcoverage.asp
The Provider Communications Group within the Center for Medicare Management established the Medlearn web page dedicated to Medicare Prescription Drug Coverage. This web page contains links to information and resources for health care professionals, beneficiary-focused information and resources, and CMS’ main MMA web page.

Medicare Provider/Supplier Web Pages

http://www.cms.hhs.gov/center/provider.asp

This is a provider specific web page with specialized information on one-stop resource pages including links to Federal Regulations and Notices, Transmittals/Change Requests, and Frequently Asked Questions. General information includes links for Coverage, Coding, and Program Integrity/Medical Review. Each page also has a Highlights section to emphasize important and timely information such as regulations, instructions for conferences. A link to subscribe to Medicare listservs is also available.

National Correct Coding Initiative (NCCI) Edits

NCCI Edits for Physicians --http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEP/list.asp
NCCI Edits for Hospital Outpatient Departments --http://www.cms.hhs.gov/NationalCorrectCodInitEd/NCCIEHOPPS/list.asp
The NCCI promotes uniformity among the contractors that process Medicare claims in interpreting Medicare payment policies. The edits are pairs of services that normally should not be billed by the same provider for the same patient on the same day.

National Medicare Training

http://www.cms.hhs.gov/MedlearnNetworkGenInfo/

National Provider Identifier (NPI)

http://www.cms.hhs.gov/NationalProvIdentStand

Contains all the NPI outreach information that CMS has prepared, as well as links to other NIP-related documents of interest to health care providers.

Practice Administration Information Resource for Medicare

http://www.cms.hhs.gov/center/practice.asp

Information and tools as they relate to Administrators, Coders, Billing Personnel, and others outside the traditional provider role

*Prescription Drug Coverage

http://www.cms.hhs.gov/MedlearnProducts/23_drugcoverage.asp

This web page contains links to basic information on drug coverage for health care professionals and people with Medicare. It also links to CMS’ main Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) web page.

Provider Frequently Asked Questions

http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_alp.php

*Publications Search Tool

http://www.medicare.gov/Publications/Home.asp

Public Comments on Regulations

http://www.regulations.gov

Your one stop site to comment on federal regulations - On this site you can find, review, and submit comments on Federal documents that are open for comment and published in Federal Register, the Government's legal newspaper.

Quarterly Provider Update

http://www.cms.hhs.gov/QuarterlyProviderUpdates/

The Quarterly Provider Update is a comprehensive resource published by the Centers for Medicare & Medicaid Services (CMS) on the first business day of each quarter. It is a listing of all non-regulatory changes to Medicare including Program Memoranda, manual changes, and any other instructions that could affect providers.

Rural Health Clinics

http://www.cms.hhs.gov/center/rural.asp

Regulations, Enrollment, Coverage, Publications, Forms, and Manuals

Skilled Nursing Facilities (SNF) PPS

http://www.cms.hhs.gov/SNFPPS/

Regulations, Publications, Rates and Indices, MDS, Swing Bed, and Frequently Asked Questions

*Supplier Directory

http://www.medicare.gov/Supplier/Home.asp

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Commerce Clearing House (CCH) Incorporated

CCH Incorporated Health and Medical Homepage

http://health.cch.com/

CCH provides information for healthcare providers regarding Medicare and Medicaid regulations.

Cornell University Law Library

Social Security Statute, (US Code Title 42, Chapter 7)

http://www4.law.cornell.edu/uscode/42/ch7.html

Department of Health and Human Services Agencies

http://www.hhs.gov/agencies/

This is a links page listing the agencies of the Department of Health and Human Services.

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Federal Bureau of Investigation

Health Insurance Fraud Information, Health Care Fraud Unit

http://www.fbi.gov/majcases/fraud/fraudschemes.htm#health

General Accounting Office

General Accounting Office FraudNET

http://www.gao.gov/fraudnet/fraudnet.htm

The General Accounting Office maintains FraudNET to facilitate reporting of allegations of fraud, waste, abuse, or mismanagement of federal funds

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Government Printing Office

Code of Federal Regulations

http://www.gpoaccess.gov/cfr/index.html

The Code of Federal Regulations (CFR) is a codification of the general and permanent rules published in the Federal Register by the Executive departments and agencies of the Federal Government.

Congressional Record

http://www.gpoaccess.gov/crecord/index.html

The Congressional Record is the official record of the proceeding and debates of the United States Congress. It is published daily when Congress is in session.

Federal Register

http://www.gpoaccess.gov/fr/index.html

The Federal Register is the official daily publication for Rules, Proposed Rules, and Notices of Federal agencies and organizations, as well as Executive Orders and other Presidential Documents.

Healthcare Financial Management Association

Healthcare Financial Management Association Homepage

http://www.hfma.org/

Corporate Compliance Resources

http://www.hfma.org/library/compliance

Tools for corporate compliance education.

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healthfinder™

*healthfinder home page

http://www.healthfinder.gov/

healthfinder™ is a gateway consumer health and human service information website from the United States government.

National Center for Policy Analysis

*Fraud in Medicare

http://www.ncpa.org/~ncpa/health/pdh5.html

The National Center for Policy Analysis is a nonprofit public policy research institute.

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National Library of Medicine

*National Library of Medicine

http://www.nlm.nih.gov

The National Library of Medicine is the word's largest medical library.

*Medline Plus

http://www.nlm.nih.gov/medlineplus
Medline Plus contains up-to-date quality health care information from the National Library of Medicine at the National Institutes of Health.

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Office of the Inspector General

Office of the Inspector General Homepage

http://oig.hhs.gov

*Office of the Inspector General Fraud Information

http://oig.hhs.gov/fraud.html

Sanctioned and Excluded Parties

http://exclusions.oig.hhs.gov/

This Cumulative Sanction Report is a listing of all parties excluded as of the date of publication.

*Office of the Inspector General Fraud Alerts

http://oig.hhs.gov/fraud/fraudalerts.html#1

Model Compliance Programs

http://oig.hhs.gov/fraud/complianceguidance.html

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Social Security Administration

*Social Security Home Page

http://www.ssa.gov

*Social Security Fraud Hotline

http://www.ssa.gov/oig/ifyou.htm

The Bureau of National Affairs

The Bureau of National Affairs Home Page

http://www.bna.com

BNA reports on developments in health care, business, labor relations, law, economics, taxation, environmental protection, safety, and other public policy and regulatory issues.