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.…
The Centers for Medicare & Medicaid Services (CMS) has released a second set of revisions to Chapter 10 of the Medicare Claims Processing Manual providing instructions to home health agencies…
Dive Brief: CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technologies.Medical device companies will now be…
Providers are calling on CMS to not finalize a proposal to collapse Medicare reimbursement for evaluation and management (E/M) visits into a single, blended payment rate for E/M Levels 2…
On Nov. 2, CMS received the 2018 final payment rule, providing a 1.2 percent increase in ASC reimbursement next year. The final rule also addressed several issues pertaining to orthopedic…
The departure of seven accountable care organizations from CMS' Next Generation ACO Model program will likely not threaten the viability of the program, but the reasons behind the early exit…