Healthcare Law Blog

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

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NCG Medical Blog

JANUARY 19, 2022

If you’re a Medicare provider , then you might want to know about MIPS—a healthcare incentive program that helps gather data of quality and performance outcomes over time while rewarding medical practices that demonstrate improvements. This program utilizes a “score” system comprised of four categories.

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Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

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Modern Healthcare

APRIL 10, 2023

The fiscal 2024 Medicare inpatient prospective payment system proposed rule from the Centers for Medicare and Medicaid Services also includes new safety and health equity provisions.

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Fierce Healthcare

JUNE 12, 2023

Industry hospital groups are pushing the Centers for Medicare & Medicaid Services to consider a higher annual pay bump and to shed some light on why it believes the number of uninsured patients | Public comments submitted to CMS by the hospital lobby were critical of a "woefully inadequate" 2.8%

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Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

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HealthIT Answers

OCTOBER 30, 2023

Deadlines: The Centers for Medicare & Medicaid Services would like to remind clinicians of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines: The post Upcoming MIPS Important Dates and Deadlines appeared first on Health IT Answers.

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HealthIT Answers

JANUARY 31, 2024

The Centers for Medicare & Medicaid Services opened data submission for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the Quality Payment Program. Data can be submitted and updated until 8:00 p.m. ET on April 1, 2024.

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Medisys Compliance

MARCH 14, 2023

Wound Care Reimbursements in Various Healthcare Settings Inpatient Hospital Wound care in an inpatient hospital setting is reimbursed through the Diagnosis-Related Group (DRG) payment system. The MPFS is a payment system that reimburses healthcare providers for services rendered to Medicare patients in an outpatient setting.

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Healthcare Law Blog

JANUARY 17, 2024

workflow and performance assessment, data analytics, and certain Medicare eligibility and performance assistance). On December 28, 2023, the Office of Inspector General (the “OIG”) issued a favorable Advisory Opinion (No. The OIG explained that the Requestor provides consulting services for practice optimization to physician practices (i.e.,

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HealthIT Answers

APRIL 18, 2023

On April 10, 2023, CMS issued the fiscal year 2024 Medicare hospital inpatient prospective payment system and long-term care hospital prospective payment system proposed rule. The post FY 2024 CMS Hospital IPPS and LTCH PPS Proposed Rule appeared first on Health IT Answers.

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Medisys Compliance

JUNE 20, 2022

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Medicare Coverage. In case any assistance needed for Medicare medical billing services, contact us at info@medisysdata.com/ 302-261-9187.

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Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. This milestone represents a major victory for the mental health professions, expanding access to much-needed care for Medicare beneficiaries and offering exciting new possibilities for MFTs and MHCs.

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Healthcare IT Today

NOVEMBER 4, 2021

While I’m not sure exactly why changes to the Hospital Price Transparency requirement happened in the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1753FC), it happened there nonetheless (Here are the details on the Federal register).

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Hanys

JUNE 30, 2023

At the request of HANYS and our federal advocacy partners, 12 members of the New York delegation joined a bipartisan letter to CMS urging the agency to adjust inadequate payment updates proposed in the FFY 2024 Medicare Inpatient Prospective Payment System rule.

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HealthIT Answers

DECEMBER 16, 2022

The Centers for Medicare & Medicaid Services would like to remind clinicians of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines: The post Reminder: Upcoming MIPS Important Dates and Deadlines appeared first on Health IT Answers.

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HIT Consultant

OCTOBER 30, 2023

The impact on eligible hospitals would be the loss of 75 percent of the annual market basket increase; for CAHs, payment would be reduced to 100 percent of reasonable costs instead of 101 percent. The Promoting Interoperability performance category score typically can be a quarter of a clinician or group’s total MIPS score in a year.

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HealthIT Answers

OCTOBER 3, 2022

The Centers for Medicare & Medicaid Services would like to remind clinicians of important upcoming Merit-based Incentive Payment System (MIPS) dates and deadlines in 2022. The post Upcoming MIPS Important Dates and Deadlines appeared first on Health IT Answers.

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Healthcare Law Today

JANUARY 20, 2023

The panel suggested providers ask themselves “What is your core competency” and “Where do local Medicare Advantage plans have gaps in their coverage and care delivery models” 2.

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Medisys Compliance

NOVEMBER 21, 2023

With Medicare Part A serving as a primary payer for many residents, understanding the intricate landscape of SNF billing is crucial to ensure proper reimbursement and compliance. Know the SNF Billing Requirements SNFs bill Medicare Part A using Form CMS-1450 (UB-04) or its electronic equivalent.

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Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). Background Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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HealthIT Answers

NOVEMBER 11, 2022

Centers for Medicare & Medicaid Services has issued final rules on the 2023 Physician Fee Schedule and the 2023 End-Stage Renal Disease Prospective Payment System. They include updates and policy changes that will take effect January 1.

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HealthIT Answers

OCTOBER 20, 2022

By Alex Baker & Elisabeth Myers - On August 1, 2022, CMS announced final changes to its payment program for acute care hospitals in 2023. The FY 2023 Inpatient Prospective Payment System final rule also included policies for the 2023 Medicare Promoting Interoperability Program, which rewards.

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Health Law Attorney

DECEMBER 18, 2020

The Centers for Medicaid & Medicare Services ( CMS ) recently released the 2021 Outpatient Prospective Payment System ( OPPS ) and Ambulatory Surgical Center ( ASC ) Final Rule, which may be accessed here. CMS will be phasing the IPO list out over the next three years, with the IPO being completely phased out by CY 2024.

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Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters.

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Hall Render

APRIL 4, 2024

The Requestor’s services further include offering physician practices training related to the Medicare Merit-Based Incentive Payment System (“MIPS”), which could result in higher Medicare reimbursement to the Requestor’s clients.

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MRO Compliance

OCTOBER 23, 2023

This transformation aims to enhance patient care quality and better align ACO reporting with the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS). These organizations received concessions from CMS to serve as early adopters and test the system.

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Payment Systems Medicare Medicare 130

Hanys

JULY 29, 2022

Charles Schumer and Kirsten Gillibrand joined 28 other senators in sending CMS a bipartisan letter asking the agency to change the final 2023 Medicare Inpatient Prospective Payment System rule, leveraging existing authority, to more accurately reflect the cost of providing hospital care to patients.

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Payment Systems Medicare Medicare Hospitals 52

Hanys

NOVEMBER 4, 2022

The Medicare Outpatient Prospective Payment System final rule for 2023 contains several HANYS advocacy priorities including a 3.8% Further details are available to members online.

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Payment Systems Medicare Medicare Hospitals 40

C&M Health Law

NOVEMBER 9, 2020

On October 29, 2020, CMS issued the Home Health Prospective Payment System final rule [ CMS-1730-F, CMS-1744-IFC, and CMS-5531-IFC ], which permanently authorizes use of telecommunications technology as part of patient care under the Medicare home health benefit. [1]. Use of Telecommunications Technology in Home Health Services.

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Healthcare IT Today

NOVEMBER 15, 2023

The technique involves finding data from public sources such as Centers for Medicare & Medicaid Services (CMS). Medicare launched a payment system for in-home treatment during the pandemic, and now more than 200 hospitals have been approved by Medicare for the service. offering in-home treatment.

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Medicare Medicare Hospitals Compliance 101

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). For Medicare, this typically includes IPPS and OPPS.

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Healthcare IT Today

DECEMBER 31, 2020

To further support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for COVID-19 related 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception applications to February 1, 2021.

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Hall Render

AUGUST 1, 2022

The proposed payment policies include an initial monthly facility fee of approximately $268,000 per month, which will adjust in future years based on a market-basket update. REHs would also get a 5 percent add-on to most outpatient payments. Proposed REH Payments. 5 Percent OPPS Increase. million per year) for 2023.

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CMS.gov

JANUARY 6, 2020

In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act – or MACRA. In an attempt to streamline multiple quality programs for physicians, the law created the Merit Based Incentive Payments System (MIPS).

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CMS.gov

OCTOBER 2, 2018

Modernizing Medicare to Take Advantage of the Latest Technologies. Administrator, Centers for Medicare & Medicaid Services. Modernizing Medicare to Take Advantage of the Latest Technologies. However, while medical technology is developing at a rapid pace, Medicare’s payment systems haven’t always been as quick to change.

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Compliancy Group

OCTOBER 5, 2023

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law to improve patient healthcare outcomes. Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. The MIPS rules for 2023 are discussed below.

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