Tagged with Medicaid Billing

2018 CMS QRDA III Implementation Guide Updates

CMS has published an updated 2018 CMS Quality Reporting Document Architecture Category III (QRDA III) Implementation Guide (IG) for Eligible Clinicians and Eligible Professionals (EPs). The update includes renaming of the Merit-based Incentive Payment System (MIPS) Advancing Care Information performance category, as well as changes to the MIPS performance period reporting.

Anthem Adopts MCG Care Guidelines

Anthem’s behavioral health medical policies and clinical guidelines currently in place for reviewing of behavioral health services, will be replaced by the MCG Care Guidelines 22nd edition Behavioral Health guidelines.

New Jersey – Legislature Passes FY 2019 Budget Bill

On July 1, the Governor of New Jersey signed the 2019 Fiscal Budget into law. The $37.4 billion budget includes increased funding for the Department of Health as well as the state’s Department of Human Services.

CMS Launches New DEL Interoperability Database

CMS has announced the launch of its Data Element Library (DEL), a new free database designed to support the exchange of electronic health information between providers and facilities.

UnitedHealthcare – Coordinated Commercial Reimbursement Policy Updates

Beginning in July, UnitedHealthcare (UHC) will make changes to some commercial reimbursement policies, including after hours and weekend care, intraoperative neuromonitoring, and its professional and technical component policy for duplicate or repeat services of global test only.