The Centers for Medicaid and Medicare Services this week released a report on complaints and enforcement efforts concerning the Public Health Service Act, which includes the No Surprises Act. As…
The 60-day Refund Rule, created by the 2010 Patient Protection and Affordable Care Act (PPACA), requires providers to report and return Medicare and Medicaid overpayments within 60 days of identifying…
The Centers for Medicare & Medicaid Services' (CMS') proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital health services,…
Federal officials are marking National Women’s Health Week with a call for awareness and reform to address stubborn disparities that have lingered historically – and to this day lead to…
CMS recently released a web-based validation tool that assists hospitals with price transparency compliance. The updated V2.0 Online Validator Tool helps hospitals develop machine-readable files to comply with a federal…
On March 27, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for Inpatient Rehabilitation Facilities (IRFs) that would update payment policies for the 2025 fiscal year…
Due to ongoing concerns with the impact the Change Healthcare cybersecurity attack is having on physician practices, the Centers for Medicare and Medicaid Services (CMS) has extended the 2023 MIPS…
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…
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…
In the post-public health emergency (PHE) era, I have noticed what I think may be a glitch in the computer system at the Centers for Medicare & Medicaid Services (CMS).…
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…
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)…
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…
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…
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…
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…