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…
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…
Various approvals, exceptions, and new PCS codes that may potentially lead to additional payments. The Centers for Medicare & Medicaid Services (CMS) desires to use the best data available when…
The CMS budget for fraud, waste and abuse has doubled in size from 2021 to 2022. Two years ago, the federal government created a plan to audit Medicare Advantage (MA) insurers more…
Remote patient monitoring may be catching on with health systems across the country, but its path to Medicare reimbursement is still a work in progress. The Centers for Medicare &…
Medicare intends next year to allow physician assistants (PAs) to begin directly billing for their work and to expand coverage of telehealth services. It also intends to change the approach…
CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a…
Hospitals are advised to offer choice to patients in terms of nursing homes, home care agencies, long-term acute-care hospitals, and inpatient rehabilitation facilities. It has now been over 18 months…
On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The…
CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to…
Proposed rules offer insight into the Administration’s priorities. The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the Biden Administration. While these rules…
CMS has codified how it defines “reasonable and necessary” coverage for items and services that may be covered under Medicare Parts A and B in a new final rule. The…
Is this “new normal” a false reality? As we are now well into October, many months into COVID-19, I think we all have to look at what all the associated…
Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including…
Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent Medicare…
Medicare outpatient payments are slated to increase by 2.6 percent next year, a $7.5 billion boost compared to 2020, according the proposed 2021 Outpatient Prospective Payment System (OPPS) rule. Released…