Minorities have been found to be disproportionately affected by adverse outcomes. Federal officials say their first monthly statistical update illustrating the impact of the COVID-19 virus on the Medicare population…
The Centers for Medicare & Medicaid Services (CMS) has provided some guidance within the “Medicare and Medicaid Programs Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency”…
Health disparities proven by Medicare claims data during the COVID-19 crisis underscore the need to transition to value-based reimbursement, according to CMS. Yesterday, the federal agency announced COVID-19 outcomes based…
Today, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment…
CMS’s IMM sends mixed messages to providers. The Important Message from Medicare (IMM) has changed significantly in its latest reiteration, and the IMM now must be presented to both Medicare…
Among the proposed new rules is one intended to clarify the contentious “Stark Law.” On Oct. 9, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to…
At the beginning of November, CMS finalized changes to its Medicare payment systems for 2020. Here's a rundown of noteworthy changes CMS made: 1. Included a site-neutral payment policy and…
The American Hospital Association (AHA) questioned the legality of site-neutral and 340B payment policies in the Outpatient Prospective Payment System (OPPS), arguing the proposals would “have a chilling effect on…
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on September 5, 2019, intended to address program integrity and vulnerability issues. The Office of the Inspector General…
The announcement is all but ensured to trouble providers already concerned about overreach. Federal healthcare oversight authorities have announced that they are expanding their “revocation and denial authorities” in an…
The case continues even after two suicides. When does an audit go beyond the reasonable and become persecution? An act of tyranny by claim denial and extrapolation? Vernon Partners LLC…
On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services…
Where the burden lies could make a difference when it comes to the RACs. In a legal lawsuit, one party is initially presumed to be correct and gets the benefit…
Today the Centers for Medicare & Medicaid Services (CMS) finalized its national coverage policy for Ambulatory Blood Pressure Monitoring (ABPM). ABPM is a non-invasive diagnostic test that uses a device…
Clinical diagnostic laboratory tests range from routine chemical measurements like blood glucose or sodium to complex examinations for cancer, infectious diseases, or rare inherited disorders. The information they provide is…
BCPI Advanced Model - The Basics As of early October, the Centers for Medicare & Medicaid Services (CMS) began to implement the Bundled Payments for Care Improvement - Advanced Model.…