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…

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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…

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Read more about the article How The CMS Final Rule Will Affect Orthopedic ASCs: 5 Key Notes
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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…

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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…

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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…

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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 &…

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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…

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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…

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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…

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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…

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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…

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Four States Get ICD-10 Deadline Extension

Four state Medicaid programs have been approved by the Centers for Medicare & Medicaid Services to delay transitioning to ICD-10 codes by the Oct. 1 deadline. California, Louisiana, Maryland and…

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8 Tips For Protecting Revenue Under ICD-10

The “Increasing Clarity for Doctors by Transitioning Effectively Now Act” is an attempt to create a 'safe harbor' for medical claim reimbursements for physician practices struggling to get ICD-10 coding…

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