Groups Claims ACA Rules Require CMS Reimbursement
Mealey's (June 15, 2015, 12:58 PM EDT) -- PORTLAND, Maine — The Center for Medicaid Services declined to issue reimbursement to a physician-training group due under the Patient Protection and Affordable Care Act (ACA) in an unsupported, arbitrary and capricious decision, the group alleges in a Sept. 26, 2014, complaint (Eastern Maine Medical Center v. Sylvia Burwell, Secretary U.S. Department of Health and Human Services, No. 14-382, D. Maine).
(Complaint available. Document #93-141029-030C.)
After each cost reporting period, Medicare Administrative Contractors (MAC) determine payment amounts due under various governing statutes, regulations and guidelines, known...