Health Law Resources


Over the past few years, we have witnessed an unprecedented evolution in the laws regulating the healthcare industry. The Department of Health and Human Services (HHS), its Office of Inspector General (OIG) and the Centers for Medicare & Medicaid Services (CMS) issue a huge amount of guidance every year regarding their programs, policies and initiatives. While much of this guidance is technical and difficult to read, it is important for providers to become acquainted with these policies to ensure that they follow the directives for billing and timely file appeals for overpayment audits. Information is key when undertaking compliance initiatives or defending your claims in the Medicare appeal process.

The main page for the Department of Justice:

http://www.justice.gov

The main page for the Centers for Medicare & Medicaid Services:

http://www.cms.hhs.gov

Additional information about the Centers for Medicare & Medicaid Services:

http://www.cms.hhs.gov/home/aboutcms.asp

A searchable database of the United States Code:

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

The Medicare Coverage Database to search for specific LCDs and NCDs applicable to your claims:

https://www.cms.gov/medicare-coverage-database/

A list of Recovery Audit Contractors (RACs):

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

More detailed information on CMS guidelines, regulations and directives:

http://www.cms.hhs.gov/home/regsguidance.asp

Medicare manuals which can be displayed online:

http://www.cms.hhs.gov/Manuals/IOM/list.asp

Below are PDF links to some important Medicare revisions called Program Transmittals:

www.cms.hhs.gov/transmittals/downloads/B03022.pdf
www.cms.hhs.gov/transmittals/downloads/B0101.pdf
www.cms.hhs.gov/transmittals/downloads/R123PI.pdf
www.cms.hhs.gov/transmittals/downloads/R184PI.pdf