Tagged with CMS
HHS Announced Key Dates for the Inflation Reduction Act’s Medicare Drug Price Negotiation Program
ahs The Inflation Reduction Act allows Medicare to negotiate directly with drug manufacturers for the prices of prescription drugs. CMS will publish the first 10 Medicare Part D drugs selected for the Medicare Drug Price Negotiation Program. The negotiated maximum fair prices for these drugs will be announced by September 1, 2024. Prices…
AHA Commended CMS for Increasing Oversight of Medicare Advantage Plans
The AHA stated that CMS had taken significant steps to increase oversight of Medicare Advantage plans. According to AHA, the CMS is working on new proposals. These proposal will tackle authorization barriers, and excessive marketing practices, among other issues. The AHA mentioned they would continue to carefully review the proposed rule and support…
Five Things for ASC Leaders to Consider with the 2023 CMS Final Rule
The CMS 2023 Medicare Physician Fee Schedule (PFS) Final Rule includes payment rate and procedures updates for physicians’ services paid under this payment schedule. The CMS Final Rule will go effective on January 1, 2023. For ASCs, these changes include increased pay rate for iTind procedures, expanded colorectal cancer screening tests coverage, added new procedures,…
OIG recommends CMS reinforce telehealth supervision after warnings of insurance fraud
A recent OIG report stated that 1,714 out of 742,000 providers billed for telehealth services that were not medically necessary or were never provided. These high-risk providers received $127.7 million in fee-for-service payments in a year. The OIG recommended the CMS strengthen monitoring telehealth services, educate providers on billing practices, and contact high-risk providers. According…
CMS Issued Hospital IPPS Final Rule for Fiscal Year 2023
CMS Final Rule updated the IPPS rates by 2.6% in FY 2023 compared to FY 2022. The rule will be effective on October 1, 2022. AHA thanked CMS for increasing the IPPS instead of cutting them as proposed. However, the association said the update still falls short regarding the healthcare needs during these times. On…
CMS Released the Proposed Outpatient Prospective Payment Rule for 2023
CMS proposed changes to determine payment rates for Medicare services paid under the OPPS and ASC payment system for CY by 2.7%. CMS estimates that total payments to OPPS and ASC providers for CY 2023 will be approximately $86.2B and $5.4B, respectively. Formal comments on the rule are accepted until September 13, 2022.…
