Tagged with Medicare Billing
CMS has named 32 participants to serve as local support for linking clinical and community services in a five-year pilot program under the Center for Medicare and Medicaid Innovation’s Accountable Health Communities model.
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.
Beginning July 1, CMS will require practitioners that are part of a group practice of ten or more that provides global services in certain states to report post-operative visits.
CMS has issued FY 2018 proposed rule for Medicare Hospital Inpatient Prospective Payment System and Long Term Acute Care Hospital Prospective Payment System. The proposal hopes to relieve regulatory burdens for providers and encourage transparency, flexibility, and innovation in care delivery.
CMS has issued the final market stabilization rule for insurers in the Affordable Care Act market that includes a shortening the open enrollment period for 2018.
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.
United Healthcare reported first-quarter revenues of $48.7 billion – a 9.4% year-over-year increase from last year. The insurer says that due to 3% insurance tax in Affordable Care Act, plan premiums will likely rise in 2018.
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.