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Navigating the Primary Care First Model

Medisys Compliance

The healthcare landscape is undergoing a dynamic transformation, driven by a growing emphasis on value-based care and patient-centered outcomes. At the forefront of this shift is the Primary Care First Model, a voluntary alternative payment model introduced by the Centers for Medicare & Medicaid Services (CMS).

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Understanding Basics of Alternative Payment Models (APMs)

Medisys Compliance

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. Incentives for Medicaid clinicians who also treat Medicare patients. APMs Overview.

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Proposed Rule on Medicare Special Enrollment Periods (SEPs)

Medisys Compliance

On 22 nd April 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. We share billing and coding updates for provider education.

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Diabetes Education Billing Guidelines for Medicare

Medisys Compliance

This criterion ensures that the training is directly relevant to the individual’s diabetes management and contributes to improving their health outcomes. These conditions are based on the beneficiary’s medical history within the 12 months prior to the start of the training.