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Elimination of LCDs Proposed

This is the year of many Centers for Medicare & Medicaid Services (CMS) regulatory requirement changes. This includes the Merit-Based Incentive Program (MIPS), the next steps toward mandatory Authorized Use Criteria (AUC) implementation for advanced imaging, defining more explicitly what is and what is not “quality” care, etc. It is important to understand that all […]

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CMS Cancels Two Mandatory Pay Models and Scales Back a Third

The CMS on Tuesday said it will toss two bundled-payment models and cut down the number of providers required to participate in a third, citing providers’ requests to have more input in the models’ designs. The agency slashed the number of mandatory geographic areas participating in the Comprehensive Care for Joint Replacement, or CJR, model […]

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CMS Targets Heart Disease With New Program

More than 500 healthcare practices have been selected to participate in a new pilot program designed to prevent heart attacks and strokes in Medicare patients, the Centers for Medicare & Medicaid Services announced Thursday. The Million Hearts Cardiovascular Disease Risk Reduction Model is the latest idea from the CMS Innovation Center, which conceptualizes and tests […]

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CMS Releases New OASIS Guidance Manual

The OASIS guidance manual set to take effect next year now is available, marking yet another step toward standardized collection of post-acute data and potential changes to the Medicare payment system.

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CMS’s Final Rule on Medicaid Managed Care

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules.

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CMS Releases 2017 ICD-10-PCS Codes

The Centers for Medicare and Medicaid Services (CMS) released the 2017 ICD-10-PCS codes as well as other supporting documentation on Thursday.

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CMS Issues Alert on ICD-9 and ICD-10 Exclusions

The Centers for Medicare and Medicaid Services (CMS) released a technical alert dated May 23, 2016 related to Non-Group Health Plan (NGHP) MMSEA Section 111 reporting.

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Louisiana Leads The Nation In Medicare Overbilling

Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to a federal report.

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CMS Posts New Medicaid IT Resources

The Centers for Medicare & Medicaid Services has launched an online resource to support states’ efforts to update outdated IT systems, Andy Slavitt, CMS’ acting administrator, announced on Monday.

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Four States Get ICD-10 Deadline Extension

Four state Medicaid programs have been approved by the Centers for Medicare & Medicaid Services to delay transitioning to ICD-10 codes by the Oct. 1 deadline.

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Is CMS Really Ready for ICD-10? Be Very Afraid

Imagine that a federal agency called the Centers for Medicare & Medicaid Services, responsible for insuring about one-third of the nation, tried to build a national health insurance exchange and the rollout was disastrous.

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CMS Issues Clarifying Questions and Answers

CMS Issues Clarifying Questions and Answers Related to the July 6, 2015 CMS/AMA Joint Announcement and Guidance Regarding ICD-10 Flexibilities

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8 Tips For Protecting Revenue Under ICD-10

The “Increasing Clarity for Doctors by Transitioning Effectively Now Act” is an attempt to create a ‘safe harbor’ for medical claim reimbursements for physician practices struggling to get ICD-10 coding correct.

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CMS Offers ICD-10 Advice for the Home Stretch

The Centers for Medicare and Medicaid Services has just released a fact sheet on preparing for ICD-10. This latest message offers suggestions for providers whose information systems may not be ready in time for the Oct. 1 transition deadline. The facts sheet also attempts to dispel some myths and issues a warning.

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CMS Accepting More Requests for ICD-10 End-to-End Testing

The Centers for Medicare and Medicaid Services has extended the deadline for applying to conduct end-to-end testing with Medicare in July. Application forms are now being accepted May 11 through May 22.

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Senate Passes Medicare Access and CHIP Reauthorization Act 92 to 8 – Avoids Payment Cuts

Closing in on two hours before the midnight deadline, the U.S. Senate on Tuesday April 14th, 2015 passed the bill in a vote of 92 to 8 to permanently end the sustainable growth rate (SGR) formula that threatened to cut physician Medicare reimbursement by 21 percent.

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