Medicare Audits: Who Bears the Burden in Your State?

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…

Comments Off on Medicare Audits: Who Bears the Burden in Your State?

CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM)

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…

Comments Off on CMS Expands Coverage of Ambulatory Blood Pressure Monitoring (ABPM)

Medicare can save millions on lab tests by creating panel codes

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…

Comments Off on Medicare can save millions on lab tests by creating panel codes

CMS Revises Claims Processing Rules for PDGM

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…

Comments Off on CMS Revises Claims Processing Rules for PDGM

CMS to revamp coding for new medical technology

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…

Comments Off on CMS to revamp coding for new medical technology
Read more about the article How The CMS Final Rule Will Affect Orthopedic ASCs: 5 Key Notes
Businessman giving a bribe. Bribery concept. Money in an envelope in hands of businessmen during corruption deal. Illustration in flat style on red background. Anti Corruption concept.

How The CMS Final Rule Will Affect Orthopedic ASCs: 5 Key Notes

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…

Comments Off on How The CMS Final Rule Will Affect Orthopedic ASCs: 5 Key Notes

CMS Next Generation ACO Changes Prompt Early Exits, Potential Lawsuit

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…

Comments Off on CMS Next Generation ACO Changes Prompt Early Exits, Potential Lawsuit

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…

Comments Off on CMS Cancels Two Mandatory Pay Models and Scales Back a Third

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 &…

Comments Off on CMS Targets Heart Disease With New Program

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…

Comments Off on CMS Releases New OASIS Guidance Manual

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. In keeping with states’ increasingly…

Comments Off on CMS’s Final Rule on Medicaid Managed Care

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. This alert communicates that…

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

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…

Comments Off on Louisiana Leads The Nation In Medicare Overbilling

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. Through…

Comments Off on CMS Posts New Medicaid IT Resources