Medicare FFS definition
Examples of Medicare FFS in a sentence
Medicare hospice services and all other Original Medicare Parts A & B services would be paid for under Medicare FFS.
For items and services that would traditionally be covered under Medicare FFS, the ICDS Plan is required to pay non-contracting Health Care Professionals and section 1861(u) providers of services the amount that the provider could collect for that service if the Beneficiary were enrolled in original Medicare (less any payments under 42 C.F.R. §§ 412.105(g) and 413.76 for section 1861(u) providers).
The MA USPCC FFS Projections provide for separate projections for Medicare FFS beneficiaries with and without end-stage renal disease (ESRD).
Specifically, Vermont and CMS shall ensure that Vermont Medicare Beneficiaries will: (1) retain full freedom of choice of providers and suppliers, as well as all rights and beneficiary protections of Medicare, and (2) retain coverage of the same care and services provided under Medicare FFS.
Enrollees can elect to disenroll from the Demonstration Plan or the Demonstration at any time and enroll in another Medicare-Medicaid Demonstration Plan, a Medicare Advantage plan, PACE, or may elect to receive services through Medicare FFS and a prescription drug plan and to receive Medicaid services in accordance with the State Plan and any waiver programs.
HCC risk scores are calculated for all Medicare beneficiaries, including Medicare FFS beneficiaries.
For services that are part of the traditional Medicare benefit package, prevailing Medicare Advantage policy will apply, under which Contractors shall pay non- contracted Providers at least the lesser of the provider’s charges or the Medicare FFS rate, regardless of the setting and type of care for authorized out-of-network services.
Election of Medicare Hospice Benefit – As in Medicare Advantage, if, after Enrollment, an Enrollee elects to receive the Medicare hospice benefit, the Enrollee will remain in the Contractor’s MMP, but will obtain the hospice service through the Medicare FFS benefit and the Contractor would no longer receive Medicare Parts A & B component of the capitated payment for that Enrollee.
The Vermont Medicare Total Cost of Care per Beneficiary Growth and All-payer Total Cost of Care per Beneficiary Growth calculations will be adjusted to incorporate any Shared Losses or Shared Savings for any Vermont ACOs participating in a Medicare FFS ACO initiative (e.g., Vermont Medicare ACO Initiative, Next Generation ACO Model, and Medicare Shared Savings Program).
This Medicare data may include individually-identifiable Medicare eligibility status and demographic information of all Medicare FFS beneficiaries residing in Vermont, and claim and claim line data for services furnished by Medicare-enrolled providers and suppliers to Medicare FFS beneficiaries residing in Vermont.