Posts Tagged ‘CMS’
CMS 2019 Medicare Fee Schedule Designed to Reduce Administrative Burdens
The Centers for Medicare & Medicaid Services (CMS) has released its 2019 Physician Fee Schedule (PFS) and the Quality Payment Program (QPP) rule, which the agency says will “address provider burnout and provide clinicians immediate relief from excessive paperwork tied to outdated billing practices.†However, a controversial payment component of the plan will be delayed…
Read MoreCMS Policy Changes to Drug Benefit Program Targets Opioid Abuse
Effective June 15, policy changes for the prescription drug benefit program finalized by the Centers for Medicare & Medicaid (CMS) take effect. CMS published the final rule updating Medicare Advantage (MA) and the prescription drug benefit program (Part D). Â The new rule is expected to result in nearly $300 million in annual savings over five…
Read MoreOIG Report Finds Improper Billing for Telemedicine Services
As the push to increase the use of telemedicine grows, so too do concerns over questionable billing practices. In a recently released report, the U.S. Department of Health and Human Services Office of Inspector General (OIG) found that the Centers for Medicare and Medicaid Services (CMS) paid practitioners for services that did not meet Medicare…
Read MoreOIG: CMS Overpaid Providers Millions in EHR Incentive Payments
The Department of Health and Human Services’ Office of Inspector General (OIG) recently released a report finding that the Centers for Medicare & Medicaid Services (CMS) overpaid some $729 million in Medicare electronic health record (EHR) incentive payments to eligible providers who did not comply with federal meaningful use requirements. In its report, the OIG…
Read MoreCMS Issues Sweeping New Rules For HHA Participation in Medicare/Medicaid
Home health agencies have six months to comply with sweeping new changes that will impact their ability to participate in the Medicare and Medicaid programs. Earlier this month, The Centers for Medicare and Medicaid, released its final rules relating to the conditions of participation (CoPs) that home health agencies must meet to participate in the…
Read MoreWhy Labs Have a Lot to Lose Under CMS’ Clinical Laboratory Fee Schedule
Big changes are coming that will impact how Medicare will pay for clinical diagnostic laboratory tests (CDLTs). The changes, according to some in the industry, could result in a significant financial hit for labs across the country because they will result in substantial fee cuts. The changes, which take effect Jan. 1, 2018, were mandated…
Read MoreJudge Orders HHS to Clear Medicare Claims Appeal Backlog by 2020
Four years, that’s how long a federal judge has given the Department of Health and Human Services (HHS) to clear through a huge backlog of Medicare claims appeals. The Dec. 5 ruling, from Judge James E. Boasberg grew out of a motion for summary judgment filed in October by the American Hospital Association. At issue…
Read MoreOIG Says Free Labeling of Test Tubes, Collection Containers Could Violate Anti-Kickback Laws
The Office of Inspector General (OIG) recently issued an advisory opinion suggesting that a laboratory’s proposal to label test tubes and specimen collection containers at no cost to dialysis facilities could constitute remuneration under the anti-kickback statute and result in potential sanctions. The opinion issued this month came at the request of an unnamed laboratory…
Read MoreCMS: Ignorance not an excuse when it comes to liability
The Centers for Medicare & Medicaid Services (CMS) recently released a policy change that provides additional conditions for determining when a contractor must assume a physician, provider, or supplier should have known about a policy or rule. Currently, CMS requires its contractors to consider at least one of three conditions when assuming that a provider,…
Read MoreCMS offers plan (again) in hopes of clearing Medicare appeals backlog
Hospital executives who are tired of waiting for their Medicare appeals cases to be settled are being presented with an option. The Centers for Medicare and Medicaid is offering to pay hospitals 66 percent of the net allowable for short-term inpatient stays in exchange for dropping their pending appeals of denied claims. CMS recently announced…
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