United Healthcare’s Medicare Advantage and the Two-Midnight Rule

Well, I suppose I have given you enough of a break from my writing about Medicare Advantage (MA) plans and the Two-Midnight Rule. Last week, United HealthCare (UHC) released its…

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CMS Says Post-Acute Care Choice Only Goes So Far

Access to post-acute care remains an issue in most hospitals around the country. Exacerbated by the staffing challenges that worsened during COVID-19, the ability to get a patient transferred to…

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CMS Sends Up Warning Flare on Discharge Planning

Back in June, the Centers for Medicare & Medicaid Services (CMS) released a memo titled “Requirements for Hospital Discharges to Post-Acute Care Providers,” which was sent to survey agencies that…

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Inside the proposed 2024 Medicare physician pay schedule

The AMA’s experts have analyzed the 2,000-page 2024 Medicare physician payment schedule proposed by the Centers for Medicare & Medicaid Services (CMS) and are sharing their summary of key provisions (PDF)…

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News Alert: CMS Releases 2024 IPPS Final Rule

While most observers of the Centers for Medicare & Medicaid Services (CMS), the release Wednesday of its final payment rule for inpatient and long-term care hospitals, caught many off-guard, expecting…

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OIG: Medicare Overpayments Due to Coding Discrepancies Totaled $22.5M

Medicare improperly paid practitioners at a higher non-facility rate for services provided to skilled nursing facility (SNF) or hospital inpatients, leading to over $22 million in over-payments, a report from…

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New Changes from CMS for HCCs Reimbursement

Hierarchical Condition Categories (HCCs) and value-based care have been a major focus for healthcare organizations during recent years. As many of you may know, the Centers for Medicare & Medicaid…

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Special Bulletin: CMS Releases IPPS Final Rule

There are no new MS-DRGs in the Final Rule. The fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) Final Rule, released by the Centers for Medicare & Medicaid Services…

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Special Bulletin: CMS Issues Proposed Rule for Physician Fee Schedule

The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care.  The Calendar Year 2023 Physician Fee Schedule (PFS) proposed rule,…

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CMS Proposes $1.6B Increase in IPPS Payment Rates for FY23

CMS has released its Hospital Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year 2023, which includes a payment rate boost for general acute care hospitals and new measures…

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Hospitals Saw Substantial Underbilling for Medicare Telestroke Services

Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with…

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CMS Updates Important Message from Medicare Instructions

The changes will become effective in about three months, giving providers time to modify processes. The staff at the Centers for Medicare & Medicaid Services (CMS) have been working overtime…

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CMS Delivers Flurry of Final Rules

Changes to the MPFS, OPPS, and HHPPS were announced on the same day. Rather than a “news dump” late on a Friday afternoon, federal healthcare officials instead served up a…

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Read more about the article CMS Releases Physician Fee Schedule Final Rule
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CMS Releases Physician Fee Schedule Final Rule

CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment…

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