Medicare and Medicaid Guide

Medicare and Medicaid Guide is the leading resource covering reimbursement for health care services and compliance. Its easy-to-use format provides the primary source information you need, and the expert guidance for using that knowledge to your best advantage.

Since its inception in 1969, the Medicare and Medicaid Guide has provided comprehensive reporting of federal Medicare and Medicaid law and regulations, case law, administrative decisions and more, expertly analyzed and explained by Wolters Kluwer editorial staff, providing health care professionals direction on how to apply the knowledge to their respective organization.

The Medicare and Medicaid Guide provides complex reimbursement, prospective payment, eligibility and coverage rules, plus federal laws and regulations, manuals, forms, and more. The correct procedures for obtaining payment are identified, as well as Medicare contractors and federal and state agencies relationships. Explanations are provided for new developments, including case annotations summarizing the issues and outcomes of any pertinent cases, decisions, laws and regulations. Primary source information includes:

  • Federal laws
  • Public laws related to healthcare
  • Federal regulations adopted by Health and Human Services (HHS)
  • Federal register issuances from CMS
  • Court decisions (cases) from federal and state courts
  • Archived cases and rulings back to 1969 (online only)
  • Administrative decisions, including DAB, PRRB, and MAC decisions
  • U.S. sentencing guidelines
  • Settlement and corporate integrity agreements
  • OIG documents
  • HITECH
  • Government Accountability Office (GAO) reports
  • Medicare Payment Advisory Commission (MedPAC) reports
  • Local and national coverage determinations from Medicare administrative contractors
  • DOJ documents
  • GAO documents
  • FTC documents
  • CMS & HHS Documents, including CMS letters, Federal Register documents, and more…

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