Tagged with Medicare Billing
CMS has posted information regarding the instances in which a Medicare Beneficiary Identifier (MBI) could be subject to change.
CMS has issued a reminder to Medicare providers regarding proper billing for certain beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program and also announced the reinstatement of QMB information in provider Remittance Advices (RAs) and Medicare Summary Notices (MSNs).
CMS has released a notice stating it will exercise enforcement discretion, through the next year, for the laboratory date of service exception policy for certain laboratory and molecular pathology tests.
Medicare will be implementing systems changes in hopes of ensuring that all Part B 837 coordination of benefits/Medicare crossover claims will not include duplicate diagnosis codes.
The House of Representatives has passed a comprehensive piece of legislation specifically designed to help combat opioid use throughout the United States.
CMS has announced that it will advance the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration to waive Merit-Based Incentive Payment System (MIPS) requirements for clinicians in certain at-risk Medicare Advantage plans.
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.
The Department of Labor (DOL), on June 18, issued a final rule that will expand consumer availability of association health plans (AHPs) as of September 1, 2018.
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.
Massachusetts – House Passes Bill to Enhance Access to High Quality Affordable and Transparent Healthcare for Community Hospitals
The Massachusetts House has passed a health care reform legislation, H.4617, that aims to lower-cost community hospitals amid changing healthcare industry cost and reimbursement pressure.
The New York Assembly has passed the New York Health Act, a legislation seeking the establishment of a universal single payer health plan that would provide comprehensive health coverage.
UnitedHealthcare (UHC) released a policy revision for molecular and genetic tests that have proven efficacy in the diagnosis or treatment of medical conditions.
A clarification for the Medicare Beneficiary Identifier (MBI) Look-up Tool has been posted regarding correct mailing and processing of new Medicare cards and MBIs.
CMS has released a redesigned version of the Drug Spending Dashboards. The updated interactive online dashboards now include year-over-year information on drug pricing and highlight which manufactures have been increasing their prices.
CMS has issued the Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services (CLFS) Subject to Reasonable Charge Payment, which details the changes in the July 2018 update, including access to data file, pricing information, and new codes.
CMS has released the latest coding changes, revisions, and feedback to National Coverage Determinations (NCDs) in the 10th revision of the ‘International Classification of Diseases (ICD-10) and Other Coding Revisions.
Blue Cross and Blue Shield of Rhode Island (BCBSRI) has updated its claims processing system. These updates became effective April 1 and include Category II performance measurement tracking codes and Category III temporary codes for emerging technology.
The New York Department of Health has released an update regarding its Medicaid Electronic Health Records (EHR) Incentive Program which provides financial incentives to eligible professionals (EPs) and hospitals to promote the transition to EHRs.
Connecticut, New Jersey, New York – Specialty Pharmacy Requirements for Certain Specialty Medications
UnitedHealthcare (UHC) will soon require Oxford Health Plan Commercial Members, participating hospitals in New York, New Jersey and Connecticut to purchase certain medications from a specialty pharmacy.
Humana has released several claims processing edits, including updates to Outpatient Prospective Payment System (OPPS), Modifiers 96 and 97, HCPCS Drugs & Biologicals, and other policies.