Medisys Compliance

APRIL 8, 2025

Definitive drug testing (CPT 80320-80377): These codes are used for confirmatory testing, typically using more sophisticated methods like mass spectrometry, to identify specific drugs and their concentrations. CMS Guidelines The Centers for Medicare & Medicaid Services (CMS) plays a significant role in laboratory billing.

Medical Billing Outsourcing 52

Medical Billing Outsourcing COVID-19 Medical Billing Medicare 52

Healthcare IT Today

JUNE 7, 2023

However, it seems that the protracted regulatory promulgation process that preceded the publication of HTI-1 was not used by ONC to push back various deadlines originally included in the proposed rule, resulting in suggested timelines that would be insufficient to complete sizable development work.

FDA 97

FDA Compliance Regulatory Compliance Medicaid 97

Innovaare Compliance

FEBRUARY 14, 2022

Operational teams—such as the Member Services Department and the Appeals & Grievances Department—have significant compliance regulations, so they must know to maintain compliance. This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Healthcare IT Today

DECEMBER 20, 2023

Health systems, hospitals, and related providers must comply with 629 discrete regulatory requirements across nine domains and spend nearly $39 billion a year on regulatory administrative activities, while an average-sized hospital dedicates 59 full-time equivalent employees to regulatory compliance, over one-quarter of whom are doctors and nurses.

Regulatory Compliance 89

Regulatory Compliance Compliance COVID-19 Hospitals 89

Health Care Law Brief

JUNE 26, 2022

Under the traditional, or fee-for-service (FFS), Medicare program, CMS directly pays providers a predetermined rate for the items and services furnished to patients under Medicare Parts A and B. CMS’s Payments to MA Plans. In turn, an MA plan pays providers a negotiated rate for the items and services they render to enrollees.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Innovaare Compliance

NOVEMBER 29, 2023

On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. This has been a very useful tool for Medicare Advantage Organizations (MAO) to check their readiness to fulfill requirements in the new contract year.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Health Care Law Brief

NOVEMBER 17, 2021

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS Final Rule). Both rules take effect January 1, 2022.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40