Also, HR 10073, or the “Medicare Patient Access and Practice Stabilization Act of 2024,” might provide some relief, Biga said. Ultimately, Cleveland said he’d like to see more long-term solutions for the same problem that physicians face every year. “The short-term relief that the Hous...
2024, that makes a number of changes to regulations governing the Programs of All-Inclusive Care for the Elderly (PACE). Among other things, the Final Rule gives CMS additional grounds on which to deny PACE organizations’ initial and service area expansion applications, imposes immunization require...
reflecting a 3.0 percent projected hospital market basket percentage increase, reduced by 0.4 percent for the productivity adjustment. This increase is 0.5 percent lower than the 3.1 percent increase implemented in the CY 2024 Final Rule. CMS aligned the...
The CMS final rule creates requirements for certain payers to streamline the prior authorization process. The rule also complements the Medicare Advantage requirements finalized in the Contract Year (CY) 2024 MA and Part D final rule, which add continuity of care requirements and reduce ...
Source: “Table 80: Surgical Procedures Being Added to the ASC CPL in CY 2023” fromCMS’ CY2023 Medicare Hospital OPPS and ASC Payment System Final Rule. While these procedures are not related to orthopedic practice, it is important to remain cognizan...
The final rule also allowed Part D plans to have a second “preferred” specialty drug tier. Drugs on this tier would be less expensive for members than the other specialty tier. Payersusethese tiers to negotiate with manufacturers. “This change gives Part D plans more too...
CMS final rule covering dialysis payments includes incentives to improve equity of careNeumann, Mark E.Nephrology News & Issues
(CMS) final rule for the calendar year 2025 Medicare Hospital Outpatient Prospective Payment System (OPPS). The rule, announced and detailed on theCMS websitelate Friday, recognizes the value of and ensures broad patient access to specialized diagnostic radiopharmaceuticals by improving the accuracy ...
CMS said in the final rule that it continues to believe that the Radiation Oncology Model “would address long-standing concerns related to RT delivery and payment, including the lack of site neutrality for payments, incentives that encourage volume of services over the value of services, and cod...
2023 rates. For CY 2023, CMS did not finalize a payment rate of ASP minus 22.5 percent for drugs and biologicals acquired through the 340B program. Instead, CMS is applying the default rate, generally ASP plus 6 percent, to 340B-acquired drugs and biologicals in this final rule for CY ...