Tagged with Hospitalist
CMS has posted a notice for physicians, hospitals, and other providers billing Medicare Administrative Contractors (MACs) to ensure the payment window edits are bypassed when processing claims for donor post-kidney transplant complications services.
On June 20, CMS released a renewed guidance to state Medicaid agencies that outlines the necessary assurances that states should make to ensure that program resources are reserved for those who meet eligibility requirements.
CMS, on June 28, released its report summary of the Affordable Care Act (ACA) risk adjustment program for the 2018 benefit year. The analysis found that 572 health insurers offering ACA plans participated in the program in 2018, and transfers between the companies totaled $10.4 billion.
CMS announced, on July 2, that it finalized its national coverage policy for Ambulatory Blood Pressure Monitoring (ABPM), extending coverage of blood pressure monitoring devices to all Medicare beneficiaries suspected of reporting abnormal blood pressure levels when administered in clinical settings.
CMS, on June 21, issued several new or updated frequently asked questions documents on the Bundled Payments for Care Improvement (BPCI) Advanced Model, an Advanced Alternative Payment Model launched last October that will run through 2023.
The CMS has re-issued a memorandum on emergency stabilization and treatment of newborn infants that could cause fresh anxiety for hospitals and physicians over abortion and care for pregnant women and severely disabled infants.
CMS has provided ICD-10-CM coding updates for the fiscal year, starting October 1, 2019 and ending September 30, 2020.
A new legislation has been introduced, that is intended to protect New York residents from unexpected surprise bills from hospital emergency department visits would give insurers the ability to pay hospitals outside their networks what they consider reasonable for emergency care, rather than what the hospital charged.
The Illinois Legislature unanimously passed a health care reform package, which requires Medicaid managed care plans to pay claims within 30 days or face a penalty.
Aetna has released updates regarding how the insurer will handle certain ambulatory surgical center (ASC) and ambulatory payment classification (APC) code edits under the ASC and APC payment methodologies.
The Medicaid and CHIP Payment and Access Commission (MACPAC) has released its 2019 Report to Congress on Medicaid and CHIP which includes recommendations Medicaid policy changes for outpatient prescription drug and hospital payments, and program integrity.
On June 24, the president signed an executive order on price transparency in health care that is intended to lower patient health care costs by providing prices for treatment prior to services being rendered.
In a notice to the Office of Management and Budget, CMS requested approval to collect public feedback on possible changes to the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS).
In a 7-1 decision, the Supreme Court ruled in favor of the nine hospitals that said the Department of Health and Human Services (HHS) violated the Medicare Act when it changed Medicare’s reimbursement adjustment formula for disproportionate share hospitals without providing notice and opportunity to comment.
Aetna has posted updated information regarding how the insurer will handle certain Ambulatory Surgical Center (ASC) and Ambulatory Payment Classification (APC) code edits under the ASC and APC payment methodologies.
The mayor of New York City has given his approval to move forward with implementation the state’s NYC Care program, an initiative to provide health care to individuals without insurance. NYC Care will be launched in the Bronx on August 1, and will be fully implemented across the city by the end of 2020.
New Jersey DHS Provides Update on MLTSS, Nursing Facility ‘Any Willing Qualified Provider’ Reimbursement Model
New Jersey’s reimbursement parameters for its MLTSS program are intended to be transitioned to a new, quality-based Any Willing Qualified Provider (AWQP) reimbursement model. DHS says it intends to award AWQP designation status to NFs this spring and review it annually.
CMS, along with the HHS, has announced plans to launch five new Medicare primary pare payment models.
CMS proposed a rule that would give the agency earlier notice of a potential sale or merger of an accrediting organization such as the Joint Commission.
The proposal updates Medicare payment policies for hospitals under the Inpatient Prospective Payment System (IPPS) for fiscal year (FY) 2020.