Tagged with Medicare Billing
The Florida Legislature has passed a bill that will institute new restrictions on prescription drugs and increase funding for addiction treatment and prevention.
CMS has issued a notice reminding providers and billing staff of the required condition codes to be used when submitting claims for device replacement procedures resulting from a recall or premature failure.
CMS has announced its new initiative for interoperability, MyHealthEData. The program has been designed to empower patients by giving them control of their healthcare data, and allowing it to follow them through their healthcare journey.
The Department of Health and Human Services (HHS) has announced its plans to overhaul the way the federal government reimburses providers. The Department states, in an effort to improve technology and transparency, it will make changes to interoperability, price transparency, and care delivery through Medicare and Medicaid, and remove regulations that hinder private innovation.
CMS has issued a notice announcing the agency will reinstate the Qualified Medicare Beneficiary (QMB) Indicator in the Medicare Fee-For-Service (FFS) Claims Processing System in an effort to prevent providers from illegally billing some Medicare beneficiaries for cost-sharing.
The Senate has reached its two-year budget deal which includes a 10 year extension to CHIP, funding to combat the opioid epidemic, and repeal of the Medicare Independent Payment Advisory Board.
On January 22nd, Humana will update its preauthorization and notification lists for all commercial fully insured, Medicare Advantage plans and dual Medicare-Medicaid plans.
CMS has released the updated Accountable Care Organization (ACO) list for the 2018 performance year of the Medicare Shared Savings Program (MSSP).
CMS on January 8th introduced its new voluntary bundled payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced).
CMS has released Part One of the 2019 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies, containing proposed changes to the Part C Risk Adjustment Model and the use of encounter data.
CMS has launched a new data submission system for clinicians participating in the Quality Payment Program (QPP), designed to reduce administrative burdens and streamline the data submission process.
CMS, on December 28th, issued a Survey and Certification Memorandum (S&C Memo) to state survey agencies to clarify and reinforce its position that it prohibits physicians and health care providers from texting orders.
The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) recently announced that the repeal of the Affordable Care Act’s (ACA) individual mandate will significantly cut the cost to fund the Children’s Health Insurance Program (CHIP) for five more years.
On March 1, 2018, UnitedHealthcare MA will require notification for injectable outpatient chemotherapy drugs given for a cancer diagnosis for members in Florida and Georgia.
Starting in 2018, more claim payments and remittance advice issued to Anthem providers will be made on a weekly basis.
CMS has posted the application fee amount for any enrollment application submitted on or after January 1, 2018 and on or before December 31, 2018.
CMS has submitted a proposed rule that, if finalized, would revise the Medicare Advantage program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act.
Healthcare New England (HNE) has issued updated anesthesia guidelines surrounding the use CPT codes and claim submissions.
CMS has finalized proposals to eliminate mandatory hip fracture and cardiac bundled payment models and decrease the scope of the existing Comprehensive Care for Joint Replacement (CJR) bundled payment initiative.
CMS has published the final payment rates and supporting documentation for the new private payor rate-based CLFS payment system.