Tagged with Medicare Billing
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.
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 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 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.
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.
CMS has extended the deadline for PQRS EHR reporting for EPs, group practices, and their vendors through March 31.
CMS released key deadlines and other important application cycle details information for applying to become a Next Generation ACO or Medicare Shared Savings Program ACO with a 2018 start date.
The U.S. Justice Department recently disclosed that there will be an investigation into four more major health insurers as part of a False Claims Act lawsuit filed against UnitedHealth Group in 2011.
CMS issued an interim final rule delaying the implementation date for new bundled payment regulations as well as the effective date of the bundled payment final rule.
CMS has modified the Medicare claims processing systems to help providers more readily identify the Qualified Medicare Beneficiary (QMB) status of each patient and to support providers’ ability to follow QMB billing requirements. Beneficiaries enrolled in the QMB program are not liable to pay Medicare cost-sharing for all Medicare A/B claims.
CMS will establish two new set-aide processes: a Liability Insurance Medicare Set-Aside Arrangement (LMSA), and a No-Fault Insurance Medicare Set-Aside Arrangement (NFMSA), effective July 2017.
The Medicare Part B specimen collection travel allowance is increasing to $1.03 per mile and $10.30 for a flat-rate trip, retroactive to January 1.
CMS has granted a broad-based waiver to Vermont which gives the state the authority to initiate an all-payer ACO pilot aimed at serving 30,000 of the state’s 190,000 Medicaid beneficiaries in 2017.
The long-anticipated legislation to repeal and replace the ACA’s core features was unveiled on March 6.
Vermont has entered into a one year agreement with OneCare to launch an ACO pilot program serving 30,000 Medicaid beneficiaries.
The DOJ moves forward with legal action against two insurers accused of erroneous coding and inflated billing – UnitedHealth and WellMed Medical Management.
UnitedHealthcare has announced its now pilot program focused on improving the overall experience of their members.
The Accredited Standards Committee X12, a group which advises on insurer standards, is recommending device identifiers (DIs) be included on medical claims forms.
CMS issued an insurance standards bulletin granting another extension to non-ACA-compliant health plans to allow insurers and consumers to extend for an additional year.
CMS recently announced its new proposed rule aimed at stabilizing ACA markets and encourage more insurers to stay on the exchanges through promoting more coverage options, and improving the risk pool for insurers.