Tagged with Medicaid Billing

CMS Releases Approved 2017 MIPS Registry List

CMS has released the 2017 list of approved qualified registries. Physician practices may utilize these third-party vendors to report individual or group data for the Quality, Advancing Care Information, and Improvement Activities categories of the Merit-Based Incentive Payment System (MIPS) in order to avoid a -4% penalty and potentially earn a small bonus in 2019.

OH – House Approves 325 Budget Amendments

The House Finance Committee has approved budget amendments that include several amendments toward the efforts of fighting the state’s heroin and opioid crisis, funding to reduce the sales tax burden on Medicaid managed care organizations, and approval requirements for Medicaid expansion.

Uninsured Rate Swells to 11.3% in Q1

Gallup-Healthways Well-Being Index poll shows uninsured rate increased to 11.3% in the first quarter of 2017 from a record low of 10.9% in the last half of 2016.

Congress to Revisit Telehealth for Chronic Care Legislation

The CHRONIC Care Act of 2017 was reintroduced to Congress this month. The proposed bill targets Medicare payment reform for chronic disease management services and would promote the use of telehealth by eliminating geographic restrictions on telestroke consult services, expand telehealth coverage under MA part B, and give ACOs more flexibility to use telehealth services.

Study Finds Federal Funding Shields State Budgets from Medicaid Expansion Costs

A new study has found that Medicaid expansion led to an 11.7% increase in overall spending on Medicaid, which was accompanied by a 12.2% increase in spending from federal funds. No significant increases were observed regarding spending from state funds from the expansion, nor any significant reductions in spending on education or other programs.

CMS 2018 MA, Part D Final Payment Rates Announced with 0.45% Increase

CMS has released 2018 Medicare Advantage and Part D payment rates, announcing a 0.45% average rate increase. According to CMS, the changes made aim at providing benefit flexibility and efficiency which will allow Medicare enrollees to choose the care that best fits their health needs.

Senate Re-introduces Bill to Expand Telehealth Services

The bill hopes to expand existing telehealth services for Medicare patients by improving Medicare reimbursements and encouraging healthcare providers to launch telehealth programs through the DHHS’ Center for Medicare and Medicaid Innovation.

CMS Pediatric Care Improvement RFI Extension Announced

CMS announced that it will extend the deadline for comments on the Request for Information (RFI) seeking input on the design of alternative payment models (APMs) focused on improving the health of children and youth covered by Medicaid and CHIP through April 7.

CMS Issues Final Rule for Medicaid DSH Payments

CMS has issued a final rule which outlines how third party payments are treated when calculating hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments.

CMS Delays Reporting Deadline for Medicare Clinical Laboratory Fee Schedule (CLFS)

CMS has announced a deadline postponement for certain laboratories to report private payer data for the new laboratory fee schedule. CMS stated the deadline was moved to May 30 due to industry feedback which suggested that many reporting entities would not be able to submit a complete set of applicable information by the initial March 31 deadline.

OH – Medicaid Oversight Committees Announce Changes to State Behavioral Health Redesign

The Ohio Department of Medicaid (ODM) and Ohio Department of Mental Health and Addiction Services (OhioMHAS) has announced two major policy and operational updates related to Behavioral Health Redesign. These policy modifications include the expansion of MH Day Treatment service for Qualified Mental Health Specialists (QMHSs) as well as the removal of the limit of 24 hours for Mental Health or SUD Nursing services per patient, per calendar year.

Aetna: Payment Reduction for X-Rays Using Film

Applicable to the technical component, claims billed with modifier FX to indicate X-ray imaging services were provided using film reduces will be subject to a 20% reduction.