Fierce Healthcare

JULY 13, 2023

The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%

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HealthIT Answers

APRIL 23, 2024

On April 10, 2024, CMS issued the fiscal year 2025 Medicare hospital inpatient prospective payment system and long-term care hospital prospective payment system proposed rule. The proposed rule would update Medicare fee-for-service payment rates and policies for inpatient hospitals and LTCHs for FY 2025.

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Hospitals Payment Systems Medicare Medicare 59

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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Payment Systems Medicare Medicare Medical Billing 52

Hanys

SEPTEMBER 13, 2024

This week, HANYS submitted comments to CMS on the Medicare Outpatient Prospective Payment System proposed rule for CY 2025.

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Payment Systems Medicare Medicare 52

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

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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Payment Systems Hospitals Medicare Medicare 86

Hanys

JUNE 14, 2024

This week HANYS submitted comments to CMS on the Medicare Inpatient Prospective Payment System proposed rule for federal fiscal year 2025.

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Payment Systems Medicare Medicare 52

Hanys

MAY 31, 2024

HANYS submitted comments to CMS on three Medicare proposed rules: Skilled Nursing Facility Prospective Payment System ; Inpatient Rehabilitation Facility PPS ; and Inpatient Psychiatric Facility PPS.

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Payment Systems Nurses Medicare Medicare 52

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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Hospitals Payment Systems Medicaid Medicaid 121

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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Hospitals Payment Systems Medicare Medicare 106

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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HIT Consultant

JUNE 24, 2024

These disincentives are implemented through existing healthcare programs: Medicare Promoting Interoperability Program: Hospitals or critical access hospitals found to be information blocking will not be considered meaningful EHR users, leading to a loss of potential financial rewards.

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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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Payment Systems Medical Billing Medicare Medicare 52

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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Medicare Medicare Medical Billing Medical Billing Outsourcing 52

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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Hospitals Payment Systems Medicare Medicare 52

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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Payment Systems Medicaid Medicaid Medicare 59

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.,

Medicare 52

Medicare Medicare Payment Systems Compliance 52

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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Payment Systems Hospitals Medicare Medicare 52

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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Payment Systems Medicaid Medicaid Medicare 52

HIT Consultant

JULY 25, 2024

What You Should Know: – Avenda Health , a pioneer in AI-powered prostate cancer care, announced today that the Centers for Medicare & Medicaid Services (CMS) has assigned a national payment rate for its prostate cancer mapping technology, Unfold AI.

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Medicare Medicare Payment Systems Medicaid 52

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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Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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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Payment Systems Medicaid Medicaid Medicare 197

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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Payment Systems Medicaid Medicaid Medicare 52

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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Medicare Medicare Payment Systems Hospitals 98

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.

Medicare 52

Medicare Medicare Patient Satisfaction Payment Systems 52

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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Medical Billing Outsourcing Medical Billing Medicare Medicare 64

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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Payment Systems Medicaid Medicaid Medicare 52

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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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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Payment Systems Medicare Medicare Hospitals 52

Healthcare IT News - Telehealth

APRIL 26, 2024

WHY IT MATTERS UnitedHealth Group, Optum's parent company, reported more than $1 billion in net losses during the first quarter – which included impacts from the February 21 Change Healthcare ransomware attack and subsequent payment systems outage.

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Payment Systems Ransomware Medicare Medicare 170

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

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

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

Hall Render

SEPTEMBER 5, 2024

On August 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year 2025 Hospital Inpatient Prospective Payment System Final Rule (“Final Rule”), finalizing the proposed Transforming Episode Accountability Model (“TEAM”). TEAM will begin on January 1, 2026.

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