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The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities. The QPP Landscape in 2025: What’s Changing? Let’s break down the updates.
Here’s what to watch for on these frontiers and more in 2025: Continued adoption of clinical note-taking tools. The Centers for Medicare & Medicaid Services (CMS) added codes for Digital Mental Health Treatment in its 2025 Medicare Physician Fee Schedules. Technology is often met with distrust among practitioners.
2025 has arrived and with it brings new challenges and potential opportunities to the healthcare landscape. Below we will discuss some strategies for payers to overcome these challenges and rest assured that they are doing all they can to innovate and change in 2025.
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions ! From 2020 to 2050, the percentage of U.S.
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
1, 2025, New York State Medicaid expanded its coverage to include remote patient monitoring services provided by clinical staff. NYS Medicaid will reimburse for RPM services under Current Procedural Terminology code 99457. With this significant change comes a huge benefit for New York citizens.
Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)
According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program.
Policy Solution #1: State Medicaid Expansion Expanding Medicaid in Alabama could bolster the finances of rural hospitals, which currently bear the substantial costs of uncompensated care for uninsured patients. However, Alabama’s political leadership remains resistant to Medicaid expansion. Senator Katie Britt (R-AL).
As we step into 2025, mental health providers must stay informed about evolving telehealth billing regulations to ensure compliance and optimize reimbursement. Will Medicare Stop Paying for Telehealth in 2025? What Is the CPT Code for Telehealth in 2025? CPT codes are essential for billing telehealth services accurately.
The budget request includes proposals for “Medicaid-like” coverage in non-expansion states and future penalties for hospitals that don’t implement cybersecurity standards.
The insurer’s Wellpoint subsidiary is expanding its ACA footprint for the 2025 coverage year, likely in a bid to capture enrollees who recently lost Medicaid coverage.
This is notification that eligible hospitals and critical access hospitals participating in the Centers for Medicare & Medicaid Services Promoting Interoperability Program that there is an upcoming data submission deadline on March 14, 2025, at 11:59 p.m. Pacific Time.
By Lauren Barca, MHA, RN - The headlines for 2025 Medicare, Medicaid, and dual-eligible programs are rife with concerns about proposed changes. While those worries were certainly a topic of discussion at AHIPs recent Medicare, Medicaid, Duals, and Commercial Markets Forum in Baltimore, Maryland, they werent the only story.
The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups.
Published April 4, 2025 Author James Lytle Share Share on LinkedIn Share on X Share on Facebook Share on Reddit Concerns over ultra-processed foods (UPFs) and their responsibility for rising rates of chronic disease and obesity have been highlighted in the medical literature and in the popular press. territories, and the District of Columbia.
This liquidity cushion is crucial for navigating ongoing headwinds and macro uncertainties, including potential changes to Medicaid. Median Medicaid reimbursement The median Medicaid reimbursement as a percentage of gross patient revenue marginally increased to 16.6% from 170.2%. in 2023 from 15.9% in 2023 from 2.8%
Just 40% of Medicare Advantage prescription drug plans offered in 2025 achieved a score of four stars or higher, the Centers for Medicare & Medicaid Services (CMS) revealed Oct. Here's how they performed for 2025. It's harder than ever for Medicare Advantage plans to score well on star ratings.
Two-thirds of healthcare organizations are considering bringing workloads from the public cloud back to private or on-premise clouds, according to the 2025 State of the Cloud report form Rackspace. Products At CES 2025, Asahi Kasei Microdevices unveiled sensors to power fall detection and wristband-based thermometers.
Key recommendations include: Extend Enhanced Tax Credits: Make permanent the enhanced marketplace premium tax credits, which are set to expire in 2025, to prevent premium increases and coverage losses. Expand Medicaid: Establish a federal fallback option to cover the millions of uninsured individuals in states that have not expanded Medicaid.
The proposed 2025 physician fee schedule from the Centers for Medicare & Medicaid Services includes payment and coding for digital health tools for behavioral health.
The 2025 convening of CES (once known as the Consumer Electronics Show) in Las Vegas officially kicks off on 7 January 2025. More granularly, Ill be looking into Sleep-tech: The square footage of CES convention floor space devoted to sleep has been significant and visible, with 2025 growing new products and sleep-tech flavors.
Medicaid and dual-eligible contracts fuel growth for the California-based insurer, but also come with upfront implementation costs that will lower its earnings this year, executives said.
Food as Medicine: This trend has emerged from its niche, driven by increased funding and partnerships, particularly within Medicare Advantage and Medicaid programs. Looking Ahead to 2025 The digital health landscape is constantly evolving.
Sufian Chowdhury, Co-Founder and CEO of Kinetik Non-Emergency Medical Transportation (NEMT) provides a critical lifeline for millions of Medicaid recipients across the United States, ensuring access to vital medical care. Duplicate Billing Charging Medicaid multiple times for the same trip or overlapping trips.
What You Need to Know: The National Committee for Quality Assurance (NCQA) has announced significant updates to its credentialing and monitoring requirements, effective July 1, 2025. Key NCQA 2025 Compliance Changes 1. The post Navigating NCQAs 2025 Credentialing & Monitoring Requirements appeared first on Verisys.
Atkins, PhD, MSW, LMSW, CPC, CIGE The governments new whistleblower complaint portal launched in April 2025 emphasizes the importance of complying with regulations related to qui tam suits, OCR investigations and protecting the rights of employees submitting a tip or complaint internally or to authorities. Written by Dr. Stacey R.
Two breach notices have been added to the Beacon Health System website, the first on March 24, 2025, involving a business associate called CPS Solutions, a provider of services to support pharmacy operations. Notification letters were mailed to the affected individuals on February 10, 2025.
twelve months ago: uncertainties about private/commercial insurance and employment-based health benefits, as well as uncertainties about Medicaid erosion, Medicare benefit access and enrollment, the status of NIH-funded and tracked clinical trials, and many other aspects of health care security play into these landscapes. .”
Explore the key trends and predictions that will shape the healthcare landscape in 2025, according to 25 industry leaders. Naveen Jain, CEO and Founder of Viome “By 2025, personalized nutrition will evolve from a niche innovation to a cornerstone of mainstream wellness.
Currently, it also is covered in some form by about 32 state Medicaid programs. If AMA makes these changes to RPM codes, coverage changes would most likely go into effect in 2025 or later. These have been the four most common general RPM codes for a few years now. Medicare was the first to cover RPM.
This aligns with recent guidance from the Centers for Medicare and Medicaid Services that Medicare Advantage plans may not make a determination of medical necessity solely based on algorithms using broad data sets. 2025) research interests are focused on the intersection of health and the law. Rebekah Ninan’s (J.D.
It's April 2025 and healthcare still waits for a permanent solution from the government for telemedicine and Medicare – which tends to drive what Medicaid and private insurers do. The current ones run out on September 30. Will October 1 find the industry with a permanent solution or another kick of the can down the road?
Here’s a quick look at some of the health IT jobs we found: Systems Analyst 1- EMR and Clinical Workflows – Oracle Manager Data Health Informatics – MLK Community Healthcare Director, Software Engineering – Midi Health Business Office Representative Clerk – Owensboro Surgery Center – SCA Health Behavioral Health (..)
Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)
On March 7, 2025, the Centers for Medicare & Medicaid Services (CMS) posted a memo dated March 10, 2025, that gives nursing homes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes. New Surveyor Guidance Memo).
Humana, one the country’s largest Medicare Advantage organizations, is suing the Centers for Medicare & Medicaid Services over its 2025 star | Humana, one the country’s largest Medicare Advantage organizations, is suing the Centers for Medicare & Medicaid Services over its 2025 star ratings results.
The HEI Reward Factor will assess how well plans serve beneficiaries with social risk factors such as low income, disability, or dual eligibility for Medicaid. Data from measurement years 2024 and 2025 will impact Star ratings in 2027.
UnitedHealthcare successfully won its lawsuit over the Centers for Medicare and Medicaid Services, a federal judge determined Nov. UnitedHealthcare will get to claim victory over CMS for its star ratings lawsuit win.
Published March 14, 2025 Author Rebekah Ninan Share Share on LinkedIn Share on X Share on Bluesky Share on Facebook Between Feb. Approximately 14 states Medicaid programs cover any form of a GLP-1 drug to treat obesity. 2025) is a student fellow with the Petrie-Flom Center. The reason for the sudden drop in its stock price?
In April 2025, two companies were discovered to have failed to conduct exclusion list checks, resulting in the employment of excluded individuals. The nurse had provided items or services that were billed to Medicare or Medicaid. Advancare Healthcare Services agreed to settle the alleged exclusion list violation, paid a $41,596.68
The Centers for Medicare & Medicaid Services (CMS) is discontinuing the Medicare Advantage (MA) Value-Based Insurance Design model at the end of 2025. | The Value-Based Insurance Design model for Medicare Advantage plans will be terminated at the end of next year.
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