“The Medicare physician payment final rule continues our work to strengthen primary care while also supporting preventive care and promoting better access to behavioral health care," said HHS Secretary Xavier Becerra in a press release. "In addition, the final rule codifies and build...
4月4日,美国医保局(CMS)发布了2025年的Medicare Advantage和Medicare Part D的最终版规则,其中对生物类似药替代的要求明显降低,Medicare Part D的所有生物类似药替换不再明确要求CMS的提前批准,而此前这一原则仅适用于可互换的(interchangeable)生物类似药。 在此之前,任何生物药处方的变更中,CMS规定保险公司、PBM或...
The Centers for Medicare & Medicaid Services (CMS) issued its2025 Physician Fee Schedule (PFS) proposed ruleearlier this month. Alongside a2.8 percent payment cutfor physicians, the rule includes numerous proposals directed at virtual care, including brand new codes for certain digital th...
Employers with group health plans that provide prescription drug coverage to Medicare-eligible individuals must submit an annual disclosure to the Centers for Medicare & Medicaid Services (CMS) whether their coverage is “creditable” or “non-creditable
Starting in July 2024, the US Centers for Medicare & Medicaid Services (CMS) will begin piloting the Making Care Primary Model at organizations in 8 states—Colorado, Massachusetts, Minnesota, New Jersey, New Mexico, New York, North Carolina, and Washington. In addition to improving care ...
The Centers for Medicare & Medicaid Services offered a glimpse into its approach for a new model aimed at lowering drug costs, which will begin in January 2025. (Getty Images/yacobchuk) Expect sickle cell disease to be the primary focus of the new Cell and Gene Therapy Access M...
The Centers for Medicare & Medicaid Services (CMS) has announced significant expansions in telehealth services, creating new opportunities for Home Healthcare in 2025. These changes aim to improve access to care, enhance patient outcomes, and reduce healthcare costs. Providers offering Home Healthcare...
The proposed policy aims to preserve the scientific integrity of clinical trials by preventing differences in Medicare payment methods from revealing patient group assignments. CMS will cover routine costs for approved clinical trials, with payment adjustments established only when necessary to prevent ...
Nearly 42% of Medicare Claims for E/M Services are Coded Incorrectly. Simply Implementing strong Quality Controls within your firm will improve coding and documentation accuracy, avoid under Payment or Over Payment and improve Quality Care.Read More ...
CMS released its Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies.