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%

Hospitals 119

Hospitals Payment Systems Medicaid Medicaid 119

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.

Payment Systems 86

Payment Systems Hospitals Medicare Medicare 86

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. These changes become effective on January 1, 2024. CMS anticipates the changes will increase MSSP participation by 10% to 20%.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

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.

Payment Systems 69

Payment Systems Medicaid Medicaid Medicare 69

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. Eligibility and Covered Services To directly bill Medicare, you must meet specific eligibility criteria. The next step involves enrolling as a Medicare provider.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

Medisys Compliance

MARCH 14, 2023

Whatever might be healthcare facility, it’s important to get accurately reimbursed for wound care services. 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.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Healthcare Law Blog

JANUARY 17, 2024

23-15 ) (the “Opinion”) to a consulting vendor (the “Requestor”) that wanted to provide up to $75 in gift cards to physician practices in exchange for referring the Requestor’s practice optimization services (e.g., workflow and performance assessment, data analytics, and certain Medicare eligibility and performance assistance).

Medicare 52

Medicare Medicare Payment Systems Compliance 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.

Payment Systems 59

Payment Systems Medicaid Medicaid Medicare 59

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. Likewise, nursing services are necessary to train and educate the patient and caregivers on the safe administration of infusion drugs in the home.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 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.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

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. million in 2019.

Payment Systems 152

Payment Systems Ransomware Medicare Medicare 152

Health Law Advisor

NOVEMBER 2, 2022

Announced in the Consolidated Appropriations Act of 2021, Rural Emergency Hospitals (REHs) will be a new type of Medicare provider starting January 1, 2023. REHs are designed to provide primarily emergency department, observation, and outpatient services.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. billion in uncompensated care payments for FY 2021, a decrease of approximately $60 million from FY 2020.

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

Medisys Compliance

FEBRUARY 9, 2024

Separate Payment for Disposable Negative Pressure Wound Therapy (dNPWT) Devices in Home Health Before January 1, 2024, home health agencies bundled dNPWT devices with other wound care services under a single billing code. This code is separate from the codes used for other wound care services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

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.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 40

Medisys Compliance

AUGUST 4, 2022

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023. Renal Dialysis Services.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

C&M Health Law

AUGUST 10, 2022

On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities (SNFs) and enacts changes to the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program beginning in FY 2023.

Medicare 52

Medicare Medicare COVID-19 Nursing Homes 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. What You Should Know: – The U.S.

Medicare 98

Medicare Medicare Payment Systems Hospitals 98

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.

Payment Systems 52

Payment Systems Medicaid Medicaid Medicare 52

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.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Health Populi

MAY 16, 2019

This very question is addressed in this week’s New England Journal of Medicine in an essay, Toward Facilitated Self-Service in Health Care. . In each of these scenarios, financial services, hospitality, and petroleum operators have bent their industry cost-curves while engaging consumers in self-service.

US Department of Health and Human Services 121

US Department of Health and Human Services Doctors Payment Systems Medicare 121

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.

Payment Systems 52

Payment Systems Medicaid Medicaid Medicare 52

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.

Payment Systems 52

Payment Systems Medicaid Medicaid Medicare 52

Hall Render

APRIL 4, 2024

Department of Health and Human Services Office of Inspector General (“OIG”) recently issued Advisory Opinion No. 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.

Payment Systems 40

Payment Systems Medicare Medicare Fraud 40

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.

Payment Systems 179

Payment Systems Medicaid Medicaid Medicare 179

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

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. Continue Reading ?.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 40

Healthcare IT News - Telehealth

APRIL 21, 2021

Cavanaugh previously has served as the deputy administrator and director of the Center for Medicare at the Centers for Medicare & Medicaid Services and as deputy director for programs and policy in the Center for Medicare & Medicaid Innovation. " Sean Cavanaugh, Aledade.

Medicare 182

Medicare Medicare COVID-19 Telemedicine 182

Healthcare IT Today

NOVEMBER 15, 2023

Their interventions, goals, and measures depend a lot on who’s paying for the service. Many employees using the service report sleeping better, feeling more confident and energetic, and other quality-of-life changes. Activation is an obvious measure because the service can’t help members if they don’t sign up.

Medicare 94

Medicare Medicare Hospitals Compliance 94

Hall Render

MAY 10, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement the Transforming Episode Accountability Model (“TEAM”), a new mandatory alternative payment model unveiled as part of the 2025 Hospital Inpatient Prospective Payment System proposed rule.

Medicare 40

Medicare Medicare Hospitals Medicaid 40

Healthcare IT News - Telehealth

DECEMBER 14, 2021

This is why, as the new year approaches, Healthcare IT News has sat down with an expert in value-based care to get his views on what 2022 will hold for the payment system. Caravan Health is a privately held company formed to create sustainable methodologies for health systems to excel in value-based care.

Medicare 173

Medicare Medicare COVID-19 Telemedicine 173

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.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

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. Importantly, however, an REH cannot provide any inpatient hospital services.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

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.

COVID-19 52

COVID-19 Payment Systems Medicaid Medicaid 52

Healthcare IT News - Telehealth

SEPTEMBER 25, 2020

The American Telemedicine Association was among several groups this week that submitted comments to the Centers for Medicare and Medicaid Services regarding the 2021 Physician Fee Schedule proposed rule. WHY IT MATTERS.

COVID-19 125

COVID-19 Telemedicine Medicare Medicare 125

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).

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Hall Render

JULY 7, 2022

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). The Proposed Rule did not contain the details of the payment policies for REHs, which CMS will develop in separate notice and comment rulemaking.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70